Colchicine for alcoholic and non-alcoholic liver fibrosis or cirrhosis

Aims/Background: Colchicine is an anti-inflammatory and antifibrotic drug. Several randomized clinical trials have addressed the question whether colc hicine has any efficacy in patients with alcoholic as well as non-alcoholic fibrosis and cirrhosis. The objectives were to assess the efficacy of colc hicine evaluated in randomized trials on mortality, liver related mortality , liver related complications, liver fibrosis markers, liver histology, alc ohol consumption, quality of life, and health economics in patients with al coholic and non-alcoholic fibrosis or cirrhosis. Methods. Interventions enc ompassed peroral colchicine at any dose versus placebo or no intervention, The trials could be double-blind, single-blind or unblinded. The trials cou ld be unpublished or published as an article, an abstract, or a letter, and no language limitations were applied. All analyses were performed accordin g to the intention-to-treat method, MET)LINE, The Cochrane Controlled Trial s Register, The Cochrane Hepato-Biliary Group Controlled Trials Register an d full text searches were combined. Results: Combining the results of 14 ra ndomized clinical trials including 1138 patients demonstrated no significan t effects of colchicine on mortality (odds ratio (OR): 0.91; 95% confidence interval (CI) 0.64, 1.31), liver related mortality (OR: 0.98, CI 0.56, 1.7 4), complications (OR: 1.06; CI 0.65, 1.73), and the other outcomes. Colchi cine was associated with a significantly increased risk of adverse events ( OR: 4.41; CI 2.24, 8.70; p < 0.001). Conclusions: Colchicine should not be used for liver fibrosis or liver cirrhosis irrespective of etiology. Future trials on colchicine for liver diseases ought to be large.