Gout flare prophylaxis starts with colchicine, but treatment can be challenging2,4-6

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Colchicine 0.6 mg
daily + ULT for at
least 6 months
is well established1,4,6,7

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Colchicine has
a narrow
therapeutic window
and may be toxic in
high-risk populations2,4,8-10

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Patients with renal impairment
or GI sensitivity have
difficulty tolerating
colchicine 0.6 mg daily—
especially older patients2,11-14

ULT = urate lowering therapy.

Precision dosing can help avoid toxicity

In patients with moderate to severe renal impairment:

Colchicine 0.6 mg daily may be too high, leading to toxicity2,15

Renal function8
— Severe renal impairment:
eGFR 15–29 mL/min/1.73 m2
— Moderate renal impairment:
eGFR 30–59 mL/min/1.73 m2
Chart adapted from Robinson et al.*
Click to see the difference 0.1 mg to 0.3 mg can make
0.6 mg 0.5 mg 0.3 mg
gloperba-chart-06d
Zoom
In patients with moderate renal impairment:

Decreasing the daily dose by just 0.1 mg can make a big difference in toxicity2,3,15

Renal function8
— Moderate renal impairment:
eGFR 30–59 mL/min/1.73 m2
GLOPERBA® plasma concentration data from Colcrys bioequivalence study; simulations of mild, moderate, severe renal impairment were simulated as described in the literature (Karatza et al, 2021) using a two-compartment pharmacokinetic model.10
Click to see the difference 0.1 mg to 0.3 mg can make
0.6 mg 0.5 mg 0.3 mg
gloperba-chart-05d
Zoom
In patients with severe renal impairment:

Colchicine 0.3 mg daily may be just right3,15

Renal function8
— Severe renal impairment:
eGFR 15–29 mL/min/1.73 m2
GLOPERBA® plasma concentration data from Colcrys bioequivalence study; simulations of mild, moderate, severe renal impairment were simulated as described in the literature (Karatza et al, 2021) using a two-compartment pharmacokinetic model.10
Click to see the difference 0.1 mg to 0.3 mg can make
0.6 mg 0.5 mg 0.3 mg
gloperba-chart-03d
Zoom

*Consensus Statement on Long-Term Low-Dose Colchicine in Gout and Cardiovascular Disease; American Journal of Medicine.

In patients with GI sensitivity:
Colchicine 0.6 mg may be too high2,10

GI toxicity is the most common adverse reaction reported with colchicine1,10-12
Many factors can exacerbate GI toxicity:

people

Pre-existing GI conditions11,12,16

Many GI conditions are more common in gout patients, including:

  • Inflammatory bowel diseases
  • Peptic ulcer
  • Gastroesophageal reflux disease (GERD)
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Current or prior history of colchicine GI intolerance2,17

Some patients struggle to tolerate colchicine pills/capsules

  • This sensitivity can be further compounded by older age18

Lower doses of colchicine are associated with lower risk of Gl toxicity2,17

Current dose reduction strategies may lead to the risk of over- or under-dosing, compromising efficacy and safety3,15

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Dosing modifications (eg, QoD) can also impact adherence19
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Splitting the small pill evenly is difficult20