Association between colchicine use and the risk of dementia among patients with gout: A nationwide retrospective cohort study

Background Recent findings suggest a link between gout and the development of dementia. Early treatment with colchicine is recommended as a first‐line therapy for gout flares. Animal studies demonstrate that colchicine could induce cognitive impairment. This cohort study aimed to investigate the ass...

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Bibliographic Details
Published in:International journal of rheumatic diseases 2024-05, Vol.27 (5), p.e15162-n/a
Main Authors: Chen, Pei‐Yun, Tseng, Chu‐Chiao, Lee, Yi‐Ting, Yip, Hei‐Tung, Chang, Renin, Wei, James Cheng‐Chung
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
cohort
Cohort analysis
Colchicine
Colchicine - adverse effects
Colchicine - therapeutic use
Comorbidity
Comparative analysis
Databases, Factual
Dementia
Dementia - chemically induced
Dementia - diagnosis
Dementia - epidemiology
Dementia disorders
Drug dosages
Female
Gout
Gout - drug therapy
Gout - epidemiology
Gout Suppressants - adverse effects
Humans
Male
Medical records
Middle Aged
Patients
propensity score
Retrospective Studies
Risk Assessment
Risk Factors
Sensitivity analysis
Taiwan - epidemiology
Time Factors
Uric acid
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Summary:Background Recent findings suggest a link between gout and the development of dementia. Early treatment with colchicine is recommended as a first‐line therapy for gout flares. Animal studies demonstrate that colchicine could induce cognitive impairment. This cohort study aimed to investigate the association between colchicine use and the risk of developing dementia. Methods In this nationwide cohort study, we performed comparative analysis on 6147 patients ≥40 years, with gout and colchicine new users against 6147 controls to assess subsequent dementia risk. The colchicine group and the control group (urate lowering therapy group) were matched on the bases of age, sex, index year, and comorbidities. All participants were followed for up to 14 years for a diagnosis of dementia considering medical records were retrospectively checked over this period. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Sensitivity analyses were performed to validate our findings. Results The adjusted hazard ratio (aHR) of dementia for colchicine users was 1.45 (95% CI = 1.05, 1.99) relative to comparison group after adjusting for sex, age, and comorbidities. Sensitivity analysis aiming to minimize underdiagnosed occult dementia at the time of index year yielded consistent positive association. In higher accumulative dose colchicine group (cumulative defined daily dose [cDDD] >30), the aHR of dementia risk for colchicine users was 1.42 (95% CI = 1.03, 1.97) compared with nonusers. For those duration of colchicine use >30 days, the aHR was 1.53 (95% CI = 1.01–2.32) compared to the nonuser group. Conclusions A significant risk of dementia was observed in this study in patients with gout using colchicine at higher cDDD and for a longer period. Further research is needed to elucidate the relationship between colchicine, gout, and dementia. Compared to use of other urate‐lowering drugs, colchicine use is associated with a 45% increased risk of new‐onset dementia in gout patients.
ISSN:1756-1841
1756-185X
DOI:10.1111/1756-185X.15162