A study published in The Lancet Respiratory Medicine May 27th 2021 by Tardif and others researched this issue in relation to colchicine.
Evidence suggests excessive inflammation in COVID-19 patients plays a role in the development of complications.
Colchicine is an oral anti-inflammatory medication beneficial in gout, pericarditis and coronary disease.
This study aimed to investigate the effect of colchicine on the outcome of COVID-19 related death or hospital admission.
The study was done in Brazil, Canada, Greece, South Africa, Spain and the USA and was led by the Montreal Heart Institute.
Patients with COVID-19 diagnosed by PCR testing or clinical criteria who were not being treated in hospital were eligible if they were at least 40 years old and had at least one high risk characteristic.
Patients were randomly assigned to receive orally administered colchicine 0.5 mg twice per day for three days and then once per day for 27 days thereafter or matching placebo.
The primary efficacy endpoint was the composite of death or hospital admission for COVID-19.
A total of 4488 patients 53.9% women medium age 54 were enrolled and 2235 patients were randomly assigned to Colchicine and 2253 to placebo.
The primary endpoint occurred in 104, 4.7% of 2235 patients in the colchicine group and 131, 5.8% of 2253 patients in the placebo group.
Among the 4159 patients with PCR confirmed COVID-19, the primary endpoint occurred in 96, 4.6% of 2075 patients in the colchicine group and 126, 6% of 2084 patients in the placebo group.
Serious adverse events were reported in 108, 4.9% of 2195 patients in the colchicine group and 139, 6.3% of 2217 patients in the placebo group.
Pneumonia occurred in 63, 2.9% of 2195 patients in the colchicine group and 92, 4.1% of 2217 patients in the placebo group.
Diarrhoea was reported in 300, 13.7% of 2195 patients in the colchicine group and 161, 7.3% of 2217 patients in the placebo group.
In community treated patients including those without a mandatory diagnostic test, the effects of colchicine on COVID-19 related clinical events was not statistically significant.
Among patients with PCR confirmed COVID-19, colchicine led to a lower rate of the composite of death or hospital admissions than placebo.
Given the absence of any orally administered therapies to prevent COVID-19 complications in community treated patients and the benefit of colchicine in patients with PCR proven COVID-19, it is argued that this safe and inexpensive anti-inflammatory agent should be considered for using those at risk of complications.
Notwithstanding these considerations, replication in other studies of PCR positive community testing treated patients is recommended.
This study provides evidence of a cheap and effective treatment to help prevent the serious complications of COVID-19 disease.
LGP, the leading London doctors’ clinic provides a full COVID related testing service as well as treatment and monitoring for patients with all aspects of COVID-19.
If you have any question whatsoever, please do not hesitate to contact the practice.
Dr Paul Ettlinger
BM, DRCOG, FRCGP, FRIPH, DOccMed