Trial reportArthritis care & research2026
Cost-Effectiveness of Low-Dose Colchicine Prophylaxis When Starting Allopurinol Using the "Start-Low Go-Slow" Approach for Gout: Evidence From a Noninferiority Randomized Double-Blind Placebo-Controlled Trial.
Trial report in Arthritis care & research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Efficacy and Safety of Ultra-Low Starting Dose Febuxostat Titration in Male Patients With Primary Gout.International journal of rheumatic diseases · 2026Trial
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
objectiveThe aim of this study was to investigate the cost-effectiveness of low-dose colchicine prophylaxis for preventing gout flares when starting allopurinol using the "start-low go-slow" approach.
methodsParticipants with gout, fulfilling the American College of Rheumatology recommendations for starting urate-lowering therapy and with serum urate ≥0.36 mmol/L (6 mg/dL), were randomly allocated (1:1) to either colchicine (0.5 mg daily) or placebo for six months with a further six-month follow-up. All participants received allopurinol, with monthly increase in dose to achieve target urate <0.36 mmol/L. The primary outcomes were incremental cost-effectiveness at the 6-month and 1-year follow-up from the health system perspective, measured by incremental net monetary benefit (INMB) at a willingness-to-pay threshold equivalent to gross domestic product per capita.
resultsTwo hundred participants were randomized to either colchicine (n = 100) or placebo (n = 100). Mean costs were higher in the colchicine group over both six months and one year (adjusted mean difference $1,848 [95% confidence interval (CI) -$321 to $4,017] and $2,282 [95% CI -$173 to $4,737], respectively). Quality-adjusted life years were slightly higher in the colchicine group over six months (adjusted mean difference 0.008 [95% CI -0.020 to 0.035]) but lower over one year (-0.015 [95% CI -0.039 to 0.010]). Treatment with colchicine was not found to be cost-effective at either 6 months or 12 months (INMB -$1,373 [95% CI -$4,287 to $1,542] and -$3,191 [95% CI -$6,274 to -$107], probability of cost-effectiveness 17.7% and 1.5%, respectively). Similar results were obtained from a societal perspective.
conclusionSix months of low-dose colchicine prophylaxis when starting allopurinol using the "start-low go-slow" approach is unlikely to be cost-effective over 12 months.
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