Ahern 1987.

Study characteristics
Methods	Study design: randomised, double‐blind, two‐arm, parallel placebo‐controlled trial Setting: Repatriation General Hospital, Daw Park, South Australia Time period: not reported Intervention: oral colchicine taken at baseline (1 mg) and every 2 hours (0.5 mg) until complete response or adverse events versus matched placebo given in the same way Sample size: not described in the published report Analysis: not described whether ITT or per protocol analysis
Participants	Number of participants Enrolled: 45 participants Randomised: 43 (22 in colchicine and 21 in placebo group) (2 participants were excluded due to their inability to understand VAS) Analysed: 43 (22 in colchicine and 21 in placebo group) Inclusion criteria Acute gout, confirmed by identification of monosodium urate crystals in synovial fluid Exclusion criteria Not described Baseline characteristics Gender: 40/43 (93%) were male across both groups High‐dose colchicine group (n = 22) No. of joints involved in group: 22 (8 large (ankle, knee or wrist) joints, 14 small (MTP, MCP or PIP) joints) Age: mean (SD) 69 (8) Age: range (in years) 55 to 85 Duration of symptoms (hours): mean (SD) 38 (51) Weight (kg): mean (SD) 71 (9) Serum uric acid (mmol/L): mean (SD) 0.55 (0.16); (normal range for serum uric acid is 0.12 to 0.45) Serum creatine (mmol/L): mean (SD) 0.14 (0.08); (normal range for serum creatine is 0.06 to 0.13) Clinical score: mean (SD) 9.5 (2.8) Pain score: mean (SD) 56 (21) Placebo group (n = 21) No. of joints involved in group: 22 (6 large (ankle, knee or wrist) joints, 16 small (MTP, MCP or PIP) joints) Age: mean (SD) 70 (8) Age range (in years): 56 to 91 Duration of symptoms (hours): mean (SD) 38 (29) Weight (kg): mean (SD) 74 (11) Serum uric acid (mmol/L): mean (SD) 0.50 (0.15); (normal range for serum uric acid is 0.12 to 0.45) Serum creatine (mmol/L): mean (SD) 0.12 (0.03); (normal range for serum creatine is 0.06 to 0.13) Clinical score: mean (SD) 10.3 (2.4) Pain score: mean (SD) 68 (21) Pre‐treatment group differences: none
Interventions	High‐dose colchicine Oral colchicine 1 mg followed by 0.5 mg every 2 hours until complete response (number of doses and total dose not specified) or adverse events (nausea, vomiting or diarrhoea) occurred Control (placebo) Matching placebo given in the same way Co‐interventions No NSAIDs or analgesics were allowed 48 hours before trial entry or during the trial
Outcomes	Outcomes evaluated every 6 hours for 48 hours by a single assessor Primary outcome Number of responders, defined as number who had a 50% decrease in pain from baseline: pain was measured on a VAS (type of VAS not described) Secondary outcomes Number of responders, defined as number who had a 50% decrease in the compounded clinical score comprising pain, tenderness on palpation, swelling and redness, each graded on a 4‐point scale (none 0, mild 1, moderate 2, severe 3) (range 0 to 12 for each affected joint) Outcomes used in this review Number of responders, defined as number who had a 50% decrease in VAS pain Time pointsused in this review 12, 24, 36 and 48 hours postintervention
Source of funding	Not reported
Notes	Trial registration: not done as the trial was conducted prior to establishment of trial registries. Competing interests: the authors declared no competing interests for this study. Withdrawals: 2 participants withdrew but their treatment groups were not specified Total adverse events High‐dose colchicine group: 22/22 (100%); the design of this study involved participants taking 0.5 mg of colchicine every two hours until complete response or adverse events (nausea, vomiting, or diarrhoea) occurred. Placebo group: 5/21 (23.8%); nausea = 5 Serious adverse events There were no serious adverse events reported in either study arm.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Computer‐generated random numbers (information received after communication with authors)
Allocation concealment (selection bias)	Low risk	Allocation was concealed and held in pharmacy (information received after communication with authors)
Blinding of participants and personnel (performance bias) All outcomes	Low risk	Matching placebo control was used, implying that participants were blinded. It was not stated in the report whether or not study personnel were blinded, however in fact both study personnel and participants were blinded (information received after communication with authors)
Blinding of outcome assessment (detection bias) Self‐reported outcomes (pain, treatment success, reduction of inflammation, function, serious adverse events, total adverse events, withdrawals due to adverse events)	Low risk	Participants were blinded for this trial (information received after communication with authors)
Blinding of outcome assessment (detection bias) Assessor‐reported outcomes (reduction of inflammation, function)	Low risk	Outcome assessors were blinded (information received after communication with authors)
Incomplete outcome data (attrition bias) All outcomes	Low risk	2 participants were excluded because of inability to understand VAS ‐ it is not clear whether or not these participants were randomised but it is unlikely that this would have affected the study outcome
Selective reporting (reporting bias)	Low risk	All prespecified outcomes were reported although it is not clear if the criterion for improvement (50% reduction from baseline score) was prespecified
Other bias	Low risk	No other potential sources of bias identified