Colchicine clearance is impaired in alcoholic cirrhosis

Authors

  • Jonathan A. Leighton,

    1. Division of Gastroenterology, Department of Medicine, The University of Texas Health Science Center at San Antonio and Audie L. Murphy Memorial Veterans Affairs Hospital, San Antonio, Texas 78284
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  • Michael K. Bay,

    1. Division of Gastroenterology, Department of Medicine, The University of Texas Health Science Center at San Antonio and Audie L. Murphy Memorial Veterans Affairs Hospital, San Antonio, Texas 78284
    Current affiliation:
    1. Albany Medical Center, Department of Gastroenterology, Albany, NY 12208
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  • Alma L. Maldonado,

    1. Division of Gastroenterology, Department of Medicine, The University of Texas Health Science Center at San Antonio and Audie L. Murphy Memorial Veterans Affairs Hospital, San Antonio, Texas 78284
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  • Steven Schenker,

    1. Division of Gastroenterology, Department of Medicine, The University of Texas Health Science Center at San Antonio and Audie L. Murphy Memorial Veterans Affairs Hospital, San Antonio, Texas 78284
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  • Dr. K. Vincent Speeg

    Corresponding author
    1. Division of Gastroenterology, Department of Medicine, The University of Texas Health Science Center at San Antonio and Audie L. Murphy Memorial Veterans Affairs Hospital, San Antonio, Texas 78284
    • Department of Medicine, The University of Texas Health Science Center, 7703 Floyd Curl Drive, San Antonio, TX 78284
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Abstract

Colchicine may have benefit in primary biliary cirrhosis and alcoholic liver disease. It is currently used in patients with impaired liver function, yet little is known about its elimination in such patients. Colchicine clearance in the rat is significantly impaired in various models of liver disease. To study this in human beings, colchicine pharmacokinetics were compared in normal subjects and patients with alcoholic cirrhosis. Colchicine clearance was impaired in the cirrhotic patients. Normal subjects had a mean clearance of 10.65 ± 1.82 ml/mm · kg, whereas cirrhotic patients had a mean clearance of 4.22 ± 0.45 ml/mm · kg (p <0.01). The half-life was 57.4 ± 14.2 min in control subjects vs. 114.4 ± 19.7 min in cirrhotic patients (p = 0.054). Volume of distribution was not different in the two groups (0.718 ± 0.1 L/kg in control subjects; 0.716 ± 0.158 L/kg in cirrhotic patients, p > 0.99). No correlation was seen between colchicine clearance and bilirubin, albumin, prothrombin time or Child-Pugh classification, but this may be the result of the small number of patients studied. Based on the values measured, it is estimated that colchicine steady state would change from an average 1.12 ng/ml in normal individuals to 2.82 ng/ml in the cirrhotic patients if 0.6 mg were taken every 12 hr. It is unknown whether this change would be clinically significant. These data show that cirrhosis impairs colchicine clearance and demonstrates that the liver is a major route of colchicine elimination. HEPATOLOGY 1991;14:1013–1015.)

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