The effect of colchicine on cancer risk in patients with immune-mediated inflammatory diseases: a time-dependent study based on the Taiwan's National Health Insurance Research Database.

BACKGROUND: To determine the effect of colchicine on cancer risk in patients with the immune-mediated inflammatory diseases (IMIDs)-related to colchicine use. METHODS: This is a time-dependent propensity-matched general population study based on the National Health Insurance Research Database (NHIRD) of Taiwan. We identified the IMIDs patients (n = 111,644) newly diagnosed between 2000 and 2012 based on the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM)-274,712, 135, 136.1, 279.49, 518.3, 287.0, 696.0, 696.1, 696.8, 420, 429.4, 710.0, 710.1, 710.3, 710.4, 714.0, 720, 55.0, 55.1, 55.9, 556. INCLUSION CRITERIA: aged ≧ 20 years, if a patient had at least these disease diagnosis requirements within 1 year of follow-up, and, these patients had at least two outpatient visits or an inpatient visit. After propensity-matched according to age, sex, comorbidities, medications and index date, the IMIDs patients enter into colchicine users (N = 16,026) and colchicine nonusers (N = 16,026). Furthermore, time-dependent Cox models were used to analyze cancer risk in propensity-matched colchicine users compared with the nonusers. The cumulative cancer incidence was analyzed using Cox proportional regression analysis. We calculated adjusted hazard ratios (aHRs) and their 95% confidence intervals (95% CIs) for cancer after adjusting for sex, age, comorbidities, and use of medicine including acetylcysteine, medication for smoking cessation such as nicotine replacement medicines (the nicotine patch) and pill medicines (varenicline), anti-inflammatory drugs and immunosuppressant drugs. RESULTS: Comparing the colchicine nonusers, all cancer risk were mildly attenuated, the (aHR (95% CI)) of all cancer is (0.84 (0.55, 0.99)). Meanwhile, the colchicine users were associated with the lower incidence of the colorectal cancer, the (aHRs (95% CI)) is (0.22 (0.19, 0.89)). Those aged < 65 years and male/female having the colchicine users were associated with lower risk the colorectal cancer also. Moreover, the colchicine > 20 days use with the lower aHR for colorectal cancer. CONCLUSION: Colchicine was associated with the lower aHR of the all cancer and colorectal cancer formation in patients with the IMIDs.

Colchicine Is a Weapon for Managing the Heart Disease Among Interstitial Lung Disease With Viral Infection: Have We Found the Holy Grail?

Background: This study investigated the effect of colchicine use on the risks of heart disease (HD), pericarditis, endocarditis, myocarditis, cardiomyopathy, cardiac arrhythmia, and cardiac failure in patients having interstitial lung disease (ILD) with virus infection (ILD cohort). Methods: We retrospectively enrolled ILD cohort between 2000 and 2013 from the Longitudinal Health Insurance Database and divided them into colchicine users (n = 12,253) and colchicine non-users (n = 12,253) through propensity score matching. The event of interest was the diagnosis of HD. The incidence of HD was analyzed using multivariate Cox proportional hazards models between colchicine users and the comparison cohort after adjustment for age, sex, medication, comorbidities, and index date based on the time-dependent analysis. Results: Colchicine users had a significantly lower risk of HD (aHR = 0.87, 95% confidence interval (CI]) = 0.82-0.92) than did the colchicine non-user. For colchicine non-users as the reference, the aHR (95% CI) of the patients who received colchicine of 2-7, 8-30, 31-150, and > 150 days were 0.89 (0.81-0.98), 0.84 (0.76-0.94), 090 (0.80-0.99), and 0.83 (0.74-0.93), respectively; regardless of duration use, the lower risk of HD persisted in colchicine users. The cumulative incidence of HD in colchicine users was significantly lower than that in the colchicine non-users (log-rank p < 0.001). Conclusion: The addition of short-term or long-term colchicine to standard medical therapy may have benefits to prevent the HD among the ILD patients concurrent with a virus infection or comorbidities even in elderly patients.

Pretreatment clinical stage predicts locoregional recurrence in patients with esophageal cancer who achieved a complete clinical response to chemoradiotherapy.

OBJECTIVE: Definitive chemoradiotherapy (dCRT) represents a curative nonsurgical treatment option for patients with esophageal cancer. However, tumor recurrence is common after dCRT, even when clinical complete response (cCR) is achieved. Here, we investigated the timing, patterns, and risk factors for recurrence in patients with esophageal squamous cell carcinoma (ESCC) who achieved cCR following dCRT. METHODS: We retrospectively examined the clinical records of patients with ESCC who achieved cCR following dCRT between 2001 and 2014. Locoregional recurrence (LR) was defined as a recurrence occurring in the esophageal lumen and/or locoregional lymph nodes. Recurrences at any other sites were considered as distant recurrences (DRs). RESULTS: A total of 102 patients who achieved cCR were included. After a mean follow-up of 54.5 months, 51 patients developed recurrences (34 LRs, 6 combined LR and DR, and 11 DRs). The cumulative 1-, 3-, and 5-year recurrence rates were 35%, 46%, and 50%, respectively. The mean time to recurrence for the 40 patients with LRs (including LRs plus LRs/DRs) was significantly shorter (281.4 days) compared with that of patients with DRs (643.6 days; P = .006), with 95% of the former being diagnosed within 2 years. Multivariate Cox regression analysis identified pretreatment clinical stage III as the only independent risk factor for LR (hazard ratio, 2.732; 95% confidence interval; 1.063-7.020; P = .037). CONCLUSIONS: Disease recurrence occurs in 50% of ESCC patients who achieve cCR following dCRT, with LR being the most common pattern. Advanced pretreatment clinical stage is an independent risk factor for LR.