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Review

 

Colchicine in crystal synovitis and beyond

1, 2, 3, 4, 5, 6, 7

 

  1. Rheumatology Unit, Policlinico Gaetano Martino, University of Messina, Italy.
  2. Rheumatology Unit, Department of Medicine and Surgery, University of Perugia, Italy.
  3. Rheumatology Unit, Department of Medicine and Surgery, University of Perugia, Italy.
  4. Rheumatology Unit, Department of Medicine and Surgery, University of Perugia, Italy.
  5. Rheumatology Unit, Policlinico Gaetano Martino, University of Messina, Italy.
  6. Centre for Gout & Metabolic, Bone and Joint Diseases, Ospedale Civile SS Giovanni e Paolo, Venice, Italy.
  7. Rheumatology Unit, Department of Medicine and Surgery, University of Perugia, Italy. roberto.gerli@unipg.it

CER20026
2026 Vol.44, N°7
PI 1297, PF 1305
Review

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Received: 10/04/2026
Accepted : 21/05/2026
In Press: 07/07/2026
Published: 14/07/2026

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.

DOI: https://doi.org/10.55563/clinexprheumatol/4of7ht

Rheumatology Article