Colchicine, an anti-inflammatory drug most often used to treat gout, prevented liver cancer in patients with hepatitis virus-related end-stage liver disease, according to a new study. Published in the October 15, 2006 issue of CANCER, a peer-reviewed journal of the American Cancer Society, the study found that over three years of follow-up, patients with viral cirrhosis treated with colchicine were significantly less likely to be diagnosed with hepatocellular carcinoma (HCC) than those who did not receive the treatment, and significantly delayed the onset of HCC in patients who did develop the disease.
HCC is the fifth leading cancer worldwide and causes over 1 million deaths per year. The primary risk factor for HCC is fibrotic liver disease, or cirrhosis. Hepatitis viruses B and C are also major risk factors, as are metabolic diseases that affect the liver. Liver disease has a wide clinical spectrum, from mild abnormal lab results to irreversible fibrosis of the liver. Much of the damage to the liver is caused by inflammation, which can be caused by acute or chronic toxin exposure or infection. Inflammation is also implicated in the progression of HCC.
Colchicine is an anti-inflammatory drug commonly used to treat diseases such as gout and psoriasis. Animal studies have found that it also inhibits fibrosis formation in the liver. However, human trials on patients with liver cirrhosis demonstrated no significant efficacy in liver disease progression. Its effect on HCC prevention and progression has never been studied.
Led by Oscar Arrieta, M.D. of the Instituto Nacional de Cancerología in Mexico City, researchers evaluated colchicine as a drug to prevent HCC in patients with liver cirrhosis. They reviewed data from 186 patients with cirrhosis of the liver due to viral disease, of whom 116 were treated with colchicine.
They found that only about one in ten (9 percent) of patients treated with colchicine developed HCC compared to more than one in four (29 percent) of untreated cirrhotic patients. In addition, if subjects developed HCC, patients who were treated with colchicine developed HCC later than those not treated with the drug. Colchicine chemoprevention delayed the diagnosis of HCC after cirrhosis onset by an average 72 months (222 months compared to 150 months). Furthermore, colchicine-treated patients survived longer than untreated patients.
These findings, according to the authors, "demonstrate that colchicine can prevent the development of HCC, independently from other factors such as age, platelet count, alpha-FP and transaminase levels."
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