Colchicine in crystal synovitis and beyond.

Authors

Fabiola Atzeni, Elena Bartoloni, Caterina Antonini, Andrea Castellucci, Angelo Tropea, Leonardo Punzi, Roberto Gerli

Published in

Clinical and experimental rheumatology. Volume 44. Issue 7. Pages 1297-1305. Epub Jul 07, 2026.

Abstract

Colchicine is an ancient drug that remains a cornerstone in the management of crystal-induced inflammatory diseases, particularly gout and calcium pyrophosphate crystal disease (CPPD). Its clinical use is supported by well-established pharmacological and mechanistic evidences, mainly derived from experimental studies. Colchicine interferes with microtubule-dependent cellular functions, inhibits neutrophil activation, and modulates NLRP3 inflammasome signalling, resulting in reduced interleukin-1β production. In addition, colchicine exerts pleiotropic anti-inflammatory effects that extend beyond crystal synovitis, including modulation of platelet-leukocyte interactions and vascular inflammation. Owing to its narrow therapeutic index, low-dose regimens and careful attention to drug-drug interactions are essential. This narrative review summarises the pharmacology, mechanisms of action, and clinical applications of colchicine in rheumatic disorders, particularly gout and CPPD, and its expanding use in cardiovascular diseases, dermatology, and other inflammatory disorders.

PMID:
42454465
Bibliographic data and abstract were imported from PubMed on 15 Jul 2026.

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