Colchicine as an oral corticosteroid sparing agent for asthma

Asthma can be treated with drugs which aim to reduce inflammation in the airways. Inhaled corticosteroids are frequently used, but occasionally individuals require oral steroids for adequate control. However, oral steroids are frequently associated with severe side-effects. Colchicine has been suggested as a useful 'add-on' therapy to oral steroid treatment with the aim of reducing the dose requirement in such asthma. There is a need for well-designed trials addressing this question before recommendations can be made.

Authors' conclusions: 

No relevant trials have been published, so there is no evidence to indicate that colchicine is beneficial or otherwise in the management of steroid-dependent asthmatic patients. There is a need for well designed randomised controlled trials to be performed.

Read the full abstract...
Background: 

Oral corticosteroids are used as a treatment for asthma, but they are often associated with serious side effects. Colchicine is an anti-inflammatory, immuno modulating agent, which could potentially have a beneficial effect in the treatment of asthma as well as act as a steroid-sparing agent.

Objectives: 

To determine the effectiveness of colchicine as an oral corticosteroid sparing agent for in the treatment of chronic asthma.

Search strategy: 

We searched the Cochrane Airways Group Specialised Register (to November 2009), SIGLE (1980 to 2001) and reference lists of potential articles. We also contacted researchers in the field.

Selection criteria: 

Randomised controlled trials investigating the addition of colchicine compared to placebo in stable steroid dependent asthmatics.

Data collection and analysis: 

No trials were found that met the inclusion criteria.

Main results: 

We were unable to perform any meta-analyses. Two small studies have assessed the efficacy of colchicine subsequent to inhaled steroid withdrawal and as a tapering agent in inhaled steroids. Both studies failed to detect a significant difference between colchicine and placebo. An update search conducted in November 2009 did not identify any new trials.

Share/Save