妊娠中コルヒチン使用で流産や奇形増加せず

リウマチ性疾患を有する女性の妊娠中のコルヒチン使用による流産や先天奇形のリスク上昇は認められないと、オーストラリアのグループがRheuma­tology（2018 57: 382-387）に発表した。

むしろFMF患者では流産が減るため使用することを推奨する。

妊娠中のコルヒチン使用については議論がある。同グループは、妊娠中のコルヒチン使用の安全性について検討した研究のメタ解析を行った。主要評価項目は流産と先天奇形、副次評価項目は児の出生体重と在胎週数とした。

解析対象は4研究で、妊娠中のコルヒチン使用に流産の増加や先天奇形との関係は認められなかった。流産の発生は、コルヒチン使用群が非使用群に比べて有意に少なかった。家族性地中海熱（FMF）の患者では、コルヒチン使用群と非使用群で児の出生体重や在胎週数に有意差は認められなかった。

FMF患者に限らず、妊娠中にコルヒチンを使用した群の児の出生体重や妊娠週数は、非使用の健康女性を含む対照群の児と有意差はなかった。

Use of colchicine in pregnancy:

a systematic review and meta-analysis.

Indraratna PL1,2, Virk S3, Gurram D4, Day RO2,5.

Author information

Rheumatology (Oxford). 2018 Feb 1;57(2):382-387. doi: 10.1093/rheumatology/kex353.

Abstract

OBJECTIVES:

Colchicine is an anti-inflammatory agent used in the treatment of several rheumatological conditions. The use of colchicine in pregnancy is controversial. The current study aimed to systematically review and meta-analyse the existing data in the literature regarding the safety of colchicine in pregnancy.

METHODS:

A systematic review was carried out using six electronic databases, identifying all relevant studies where colchicine was administered to pregnant women, and where pregnancy-related outcomes were measured. The primary endpoints were miscarriage and major foetal malformation. Secondary endpoints included birthweight and gestational age at birth.

RESULTS:

Four studies were included for meta-analysis. Use of colchicine throughout pregnancy was not associated with an increased incidence of miscarriage or major foetal malformations. The incidence of miscarriage was significantly lower in women who took colchicine compared with those that did not. In women with FMF who took colchicine throughout the pregnancy, there was no significant difference in birthweight or gestational age compared with those who did not take colchicine. When not limited to FMF, colchicine use was associated with a significantly lower birthweight and gestational age compared with a control group including healthy women who did not take colchicine.

CONCLUSIONS:

Colchicine therapy did not significantly increase the incidence of foetal malformations or miscarriage when taken during pregnancy. Colchicine therapy for FMF should not be withheld on this basis during pregnancy.