Intervention Review

Colchicine for alcoholic and non-alcoholic liver fibrosis and cirrhosis

  1. Andrea Rambaldi*,
  2. Christian Gluud

Editorial Group: Cochrane Hepato-Biliary Group

Published Online: 20 APR 2005

Assessed as up-to-date: 15 FEB 2005

DOI: 10.1002/14651858.CD002148.pub2


How to Cite

Rambaldi A, Gluud C. Colchicine for alcoholic and non-alcoholic liver fibrosis and cirrhosis. Cochrane Database of Systematic Reviews 2005, Issue 2. Art. No.: CD002148. DOI: 10.1002/14651858.CD002148.pub2.

Author Information

  1. Copenhagen Trial Unit, Centre for Clinical Intervention Research, Department 3344, Rigshospitalet, Copenhagen University Hospital, Cochrane Hepato-Biliary Group, Copenhagen, Denmark

*Andrea Rambaldi, Cochrane Hepato-Biliary Group, Copenhagen Trial Unit, Centre for Clinical Intervention Research, Department 3344, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, Copenhagen, DK-2100, Denmark. arambaldi@hotmail.com. rambaldi.andrea@libero.it.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 20 APR 2005

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Alcohol and hepatotropic viruses cause the majority of liver cirrhosis in the Western World. Colchicine is an anti-inflammatory and anti-fibrotic medication. Several randomised clinical trials have addressed the question whether colchicine has any efficacy in patients with alcoholic or non-alcoholic fibrosis and cirrhosis.

Objectives

To assess the beneficial and harmful effects of colchicine in patients with alcoholic or non-alcoholic fibrosis or cirrhosis, excluding patients with primary biliary cirrhosis.

Search methods

The Cochrane Hepato-Biliary Group Controlled Trials Register, The Cochrane Controlled Trials Register on The Cochrane Library, MEDLINE, EMBASE, Science Citation Index Expanded, and full text searches were combined (September 2004). Manufacturers and researchers in the field were also contacted.

Selection criteria

We included randomised trials irrespective of blinding, language, or publication status comparing per oral colchicine with placebo or no intervention for patients with fibrosis or cirrhosis induced by either alcohol, virus, or unknown factors (cryptogenic).

Data collection and analysis

The statistical package (RevMan Analyses) provided by The Cochrane Collaboration was used. The methodological quality of the randomised clinical trials was evaluated.

Main results

We could include 15 randomised clinical trials with 1714 patients. We found no significant effects of colchicine versus placebo/no intervention on mortality (relative risks (RR) 1.00, 95% confidence interval (CI) 0.87 to 1.16), liver-related mortality (RR 1.08, 95% CI 0.88 to 1.33), complications (RR 1.01, 95% CI 0.74 to 1.38), liver biochemistry, liver histology, or alcohol consumption (RR 1.03, 95% CI 0.77 to 1.39). Colchicine was associated with a significantly increased risk of serious adverse events (RR 8.38, 95% CI 1.08 to 65,2) and non-serious adverse events (RR 4.35, 95% CI 2.16 to 8.77).

Authors' conclusions

Colchicine should not be used for alcoholic, viral, or cryptogenic liver fibrosis or liver cirrhosis outside randomised clinical trials.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Evidence supporting colchicine for alcoholic, viral, and cryptogenic liver fibrosis/cirrhosis is still lacking

Alcohol and hepatotropic viruses are major causes of liver fibrosis and liver cirrhosis. Colchicine is an anti-inflammatory and anti-fibrotic drug. This systematic review could not demonstrate any significant beneficial effects of colchicine on mortality, liver-related mortality, liver complications, liver biochemistry, or liver histology of patients with liver fibrosis or liver cirrhosis due to alcohol, hepatitis B, hepatitis C, or unknown etiology. Colchicine was associated with a significant increase in adverse events. Accordingly, there seems to be no evidence for using colchicine for alcoholic, viral, or cryptogenic liver fibrosis/cirrhosis outside randomised clinical trials.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

秋水仙素(Colchicine)治療酒精性和非酒精性肝臟纖維化和肝硬化

酒精和嗜肝病毒是導致西方世界導致大部分肝硬化的原因。秋水仙素是一種抗發炎和抗肝纖維化藥。 一些隨機臨床試驗已著眼於秋水仙素是否能夠有效治療酒精性或非酒精性肝臟纖維化和肝硬化的病人的問題。

目標

評估秋水仙素治療酒精性或非酒精性肝臟纖維化和肝硬化的病人的利弊,不包括原發性膽汁性肝硬化病人。

搜尋策略

搜尋The Cochrane HepatoBiliary Group Controlled Trials Register 、CochraneLibrary的The Cochrane Controlled Trials Register、MEDLINE、 EMBASE、Science Citation Index Expanded和全文搜索 (2004年9月)。同時聯繫廠商和該領域的研究人員。

選擇標準

收納口服秋水仙素相對於安慰劑或無處置於治療因酒精、病毒或原因不明引起的肝臟纖維化或肝硬化病人的隨機試驗,不受盲法,語言或發表狀況的限制。

資料收集與分析

使用Cochrane Collaboration提供的統計套裝軟體(RevMan 分析)。並且評估隨機臨床試驗的研究方法品質。

主要結論

收納15項隨機臨床試驗,共1714位病人。我們發現在死亡率(相對風險度 (RR) 1.00, 95%CI0.87 – 1.16),和肝臟有關死亡率(RR 1.08, 95% CI 0.88 1.33),併發症、肝臟生化學、肝臟病理、酒精消耗(RR 1.03, 95% CI 0.77 1.39)等方面,秋水仙素(Colchicine)和安慰劑/無處置沒有顯著差異。秋水仙素和出現嚴重的不良事件(RR 8.38, 95% CI 1.08 65,2)和非嚴重不良事件 (RR 4.35, 95% CI 2.16 – 8.77).的比例增加相關。

作者結論

秋水仙素不應用於治療隨機臨床試驗以外的酒精性、病毒性或原因不明的肝臟纖維化或肝硬化。

翻譯人

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

秋水仙素對酒精性,病毒性和原因不明的肝臟纖維化/肝硬化的治療仍然缺乏支持的證據。酒精和嗜肝病毒是引起肝臟纖維化和肝臟肝硬化的主要原因。秋水仙素是一種抗炎和抗肝纖維化藥物。 本系統性文獻回顧顯示對於因酒精、B肝病毒、C肝病毒或未知病原引起的肝纖維化或肝硬化病人秋水仙素在死亡率、和肝相關死亡率、肝併發症、肝生物化學、或肝病理方面沒有明顯益處。 秋水仙素和不良事件的明顯上升有關。因此沒有證據指出秋水仙素可以在隨機臨床試驗以外的領域治療酒精性,病毒性或原因不明的肝臟纖維化/肝硬化病人。