Gout Medicine May Help Victims of Cirrhosis of Liver, Study Finds

A widely used anti-gout medication may prolong the survival of some people with cirrhosis of the liver, according to a new study by researchers in Mexico City.

The findings, being published in the New England Journal of Medicine today, document what the researchers called a “striking, consistent” benefit of the inexpensive drug colchicine.

The five-year survival rate was 75%in the 54 patients who received the drug, more than twice the survival rate in the 46 patients who took placebos.

‘First’ Is Claimed

Cirrhosis is a chronic, progressive scarring of the liver, commonly the result of alcohol abuse and some hepatitis viruses. Until now, doctors have treated the symptoms of cirrhosis but have been able to do little to control the underlying disease.

“We are the first ones to show that you can really do something for the cirrhosis patient,” said Dr. Marcos Rojkind, who directed the study at the Salvador Zubiran National Institute for Nutrition in Mexico City. The researchers speculated that colchicine may block and perhaps reverse liver inflammation and scarring.

But an editorial in the medical journal said the “promising” results should be interpreted with caution until they are confirmed by other studies. The editorial, by Drs. James L. Boyer and David F. Ransohoff of Yale Medical School pointed out that by chance, patients who took the drug in the study were not as sick as the people enrolled in a comparison group.

“These questions about chance, bias and biologic factors tend to weaken an endorsement of what is otherwise the most impressive outcome yet described for any treatment of patients with cirrhosis,” Boyer and Ransohoff wrote.

Many liver experts are familiar with colchicine therapy for cirrhosis, which has been discussed at medical meetings. Some recommend routine use of the treatment, which costs about 20 cents a day, while others contend that more research is necessary.

At the National Institute of Diabetes, Digestive and Kidney Diseases, Dr. Jay Hoffnagle said many experts remain skeptical about the drug, and he believes it should not be given routinely for cirrhosis.

‘Relative Lack of Side Effects’

“I think half of the enthusiasm for it has been the relative lack of side effects,” he said.

However, Dr. Thomas Lamont of Boston University Medical Center said he thinks colchicine should be offered to victims of cirrhosis.

“While it’s a flawed study,” he said, “we have no other simple medical therapy for this disease. Coupled with abstinence from alcohol, which we firmly believe in, this therapy is certainly worth further consideration.”

The two major side effects of the treatment are diarrhea and gastritis, or inflammation of the stomach.