Philip Neustrom
Colchicine, a drug used to treat gout, has been proposed as a COVID-19 therapeutic.
COVID-19 trials
The UK's RECOVERY trial closed their trial of colchicine in hospitalized patients due to futility:
The preliminary analysis is based on 2178 reported deaths among 11,162 randomised patients, 94% of whom were being treated with a corticosteroid such as dexamethasone. There is no significant difference in the primary endpoint of 28-day mortality (20% colchicine vs. 19% usual care alone; risk ratio 1.02 [95% confidence interval 0.94-1.11]; p=0.63). Follow-up of patients is ongoing and final results will be published as soon as possible.
Interim analysis of a small number of participants (n=35) in a randomized, double-blind, placebo controlled trial of colchicine showed hints of promise:
The use of colchicine reduced the length of both, supplemental oxygen therapy and hospitalization. Shortly less than half of the patients of the Colchicine group stopped receiving supplemental oxygen until day 2. Clinical improvement was in parallel with a reduction on serum levels of C-reactive protein. ..Clinical trials with larger numbers of patients should be conducted to further evaluate the efficacy and safety of colchicine as an adjunctive therapy for hospitalized patients with moderate to severe COVID-19.
In March of 2020, the "Colchicine Coronavirus SARS-CoV2 Trial (COLCORONA)" trial of colchinine for COVID-19 began. It returned promising results in the outpatient trial:
This result obtained for the global study population of 4488 patients approached statistical significance. The analysis of the 4159 patients in whom the diagnosis of COVID-19 was proven by a naso-pharyngeal PCR test has shown that the use of colchicine was associated with statistically significant reductions in the risk of death or hospitalization compared to placebo. In these patients with a proven diagnosis of COVID-19, colchicine reduced hospitalizations by 25%, the need for mechanical ventilation by 50%, and deaths by 44%.
A meta-analysis of colchicine's impact on mortality in COVID-19 patients was published in January, 2021:
The findings of the present meta-analysis suggest a definite signal of benefit of mortality with the addition of colchicine in patients with COVID-19. The small number of studies and the relatively small absolute number of patients included certainly warrant caution as to any definitive conclusion, but this signal cannot be ignored, considering the scarcity of effective treatments for COVID-19.
