Breakthrough on cirrhosis

Pamphlet by: American Liver Foundation, Sept 23, 1991

A major breakthrough in the treatment of cirrhosis was reported at the annual meeting of the American Association for the Study of Liver Diseases in October 1987.

Colchicine, a drug used for centuries to treat gout, has been found to significantly improve survival of patients with cirrhosis after 30 months of treatment.

Dr. David Kershenobich of the National Institute of Nutrition in Mexico City and Dr. Marcos Rojkind of the Center of Advanced Studies of the National Polytechnical Institute in Mexico have been working for several years on the basic mechanisms leading to cirrhosis, the progressive formation of scar tissue that results in impaired liver function and is among the leading causes of death worldwide. Cirrhosis results from various liver diseases.

An experimental model indicated that colchicine was effective in preventing scar formation and improving liver cell function. The results were published in 1973 and lead to a randomized controlled trial. A partial account of this study was published in 1979.

After 10 years of followup, Drs. Kershenobich, Rojkind and their associates in Mexico City reported to the AASLD that colchicine treatment effectively improved patients' survival. The cumulative 5-year survival in the colchicine group was 75 per cent, as compared to 34 per cent in the untreated group. At 10 years, the survival rates were 56 per cent and 20 percent, respectively.

Improvement of the liver biopsy was seen in 9 of 51 patients on colchicine, while none was seen in untreated patients. All the surviving patients remained stable and some even showed slight improvement of their clinical and laboratory status. No significant side effects were reported.

Dr. Rojkind has recently joined the faculty at Albert Einstein College of Medicine in New York City, where he is continuing work directed towards the better understanding and treatment of this chronic liver disease that affects people of all ages. It has been estimated that 20-40 people per 10,000 die each year from cirrhosis. Most are between the ages of 30 and 60. In the Western world, 60 percent of the deaths are due to alcoholic liver disease. The other 40 percent have various causes, including viral hepatitis and some metabolic abnormalities.

The authors concluded that colchicine significantly extended the life of patients with cirrhosis. Although it is not a miracle drug providing an instant cure, its beneficial effect represents a major breakthrough.

Until now, treatment aimed at relieving symptoms, rather than modifying the course of the disease.