TOPLINE

Patients with knee osteoarthritis (OA) who received daily colchicine for 3 months showed no difference in knee pain reduction compared with those who received placebo; however, significant reductions were observed in the levels of some OA-related biomarkers.

METHODOLOGY

• Researchers conducted a 3-month placebo-controlled trial at NYU Langone Health to evaluate whether daily colchicine reduced knee pain and improved knee function in patients with symptomatic knee OA.
• They enrolled 120 participants (mean age, 66.8 years; 33% men) with symptomatic knee OA and a baseline pain score ≥ 30 on a 100-mm visual analog scale (VAS). Participants did not use oral or topical nonsteroidal anti-inflammatory drugs during the study period.
• Participants were randomly assigned to receive daily colchicine (n = 60) or a matching placebo (n = 60) for 3 months; participants received either 0.8 mg or 0.6 mg of colchicine depending on enrollment timing. Of these, 49 in the colchicine group and 51 in the placebo group completed the study.
• The primary outcome was a change in the VAS pain score from baseline to 3 months, with changes compared between the two groups.
• Secondary outcomes were changes in the Knee Osteoarthritis Outcome Score (KOOS), effusion depth, acetaminophen use, and changes in the levels of OA-related serum biomarkers.

TAKEAWAY

• From baseline to 3 months, VAS pain scores reduced significantly in both the placebo and colchicine groups (P = .0003 and P = .01, respectively). However, the mean improvements in pain scores did not differ significantly between the groups, with no added benefit even among participants with more severe pain, worse radiographic disease, or synovial effusions.
• No significant differences were observed in the KOOS and synovial effusion depth between the colchicine and placebo groups.
• Colchicine treatment was associated with reductions in high-sensitivity C-reactive protein and beta-nerve growth factor levels compared with placebo treatment (both P < .05).
• The percentage of patients experiencing treatment-related adverse events was similar between the groups; treatment compliance was comparable between the groups (81% of participants in the placebo group and 78% of participants in the colchicine group).

IN PRACTICE

"[The study] results do not support an early clinical benefit of daily administration of colchicine for symptomatic KOA [knee OA] pain and function. In contrast, the biospecimen analyses identified improvements in multiple OA-associated biochemical markers, and provide insights into the potential of colchicine to produce biochemical changes that may lead to delayed effects," the authors wrote.

SOURCE

The study was led by Jonathan Samuels, MD, NYU Grossman School of Medicine in New York. It was published online on August 23, 2026, in Seminars in Arthritis and Rheumatism.

LIMITATIONS

The 3-month study duration may have been too short to capture pain or functional improvements. Biomarker measurements were collected only at baseline and 3 months, limiting assessment of longer-term impact. The study could not evaluate whether colchicine might delay or halt structural progression of knee OA.

DISCLOSURES

The study was supported by a Rheumatology Research Foundation/American College of Rheumatology Investigator Award and an investigator-initiated grant from Hikma Pharmaceuticals, which also provided the study drug and matched placebo. Two authors reported serving as consultants for various companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.