**Yoon-Jeong Oh and Ki Won Moon \***

Division of Rheumatology, Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon 24289, Korea; yjgark640@gmail.com

**\*** Correspondence: kiwonmoon@kangwon.ac.kr; Tel.: +82-33-258-9470; Fax: +82-33-258-2455

Received: 5 April 2020; Accepted: 12 May 2020; Published: 15 May 2020

**Abstract:** Colchicine has been effectively used to prevent acute flares in patients with gout, but drugrelated adverse events have frequently occurred. We investigated whether colchicine therapy with febuxostat is associated with hepatotoxicity in gout patients. Gout patients treated with (*n* = 121) or without (*n* = 57) colchicine were enrolled upon initiating febuxostat as a urate-lowering treatment, and clinical and laboratory data at diagnosis were compared. Logistic regression analysis was performed to evaluate the risk factors related to hepatotoxicity. Median age of the with-colchicine and withoutcolchicine groups was 51.0 (37.0–62.0) and 56.0 (43.5–68.5) years, respectively. During the three months of febuxostat prescription, the prevalence of hepatotoxicity was 13/121 (10.9%) in the with-colchicine group and 4/57 (7.0%) in the without-colchicine group, without statistical significance. The rate of colchicine use was not different between the study subjects with or without hepatotoxicity (76.5% vs. 67.1%, *p* = 0.587). Pre-existing liver disease was significantly associated with increased risk of hepatotoxicity after febuxostat treatment (odds ratio, 4.083; 95% confidence interval, 1.326–12.577; *p* = 0.014). Colchicine may be safely used as a prophylactic agent for gout patients with febuxostat. However, upon initiating febuxostat, it is recommended to monitor the development of acute liver injury in gout patients with underlying liver disease.

**Keywords:** gout; febuxostat; colchicine; hepatotoxicity; prophylaxis
