Colchicine may improve outcomes for hospitalized patients with COVID-19
medwireNews: The addition of colchicine to standard treatment reduces the duration of supplemental oxygen therapy and time to hospital discharge among patients with moderate-to-severe COVID-19, suggest findings from a randomized controlled trial.
Rene Oliveira (University of São Paulo, Ribeirão Preto, Brazil) and co-investigators report that supplemental oxygen was required for a median of 4.0 days among the 36 participants who were randomly assigned to receive colchicine in addition to local standard treatment, compared with a median of 6.5 days for the 36 participants given add-on placebo, a significant difference.
Colchicine was given at a dose of 0.5 mg three times daily for 5 days, followed by 0.5 mg twice daily for 5 days, with dose adjustment based on bodyweight and kidney function.
Its use also resulted in a significantly shorter median duration of hospital stay compared with placebo, at 7.0 versus 9.0 days.
These endpoints “have relevance for daily practice in the COVID-19 pandemic, by reducing the length of hospitalisation, consequently diminishing costs and the need for hospital beds,” write the researchers in RMD Open.
The investigators also found that a significantly smaller proportion of patients treated with colchicine versus placebo required supplemental oxygen at days 2 (67 vs 86%) and 7 (9 vs 42%), and colchicine-treated patients were less likely to remain in hospital at days 7 (42 vs 72%) and 10 (9 vs 39%).
In accordance with these results, levels of C-reactive protein (CRP) decreased more rapidly in the colchicine compared with the placebo group, with median levels of 4.3 and 8.4 mg/dL, respectively, at day 2.
Taking into account the impact on both CRP and the requirement for supplemental oxygen, “colchicine use seems promising if we consider that the systemic inflammation was safely halted in a shorter period compared with the standard treatment,” say Oliveira and team.
They report that colchicine was well tolerated overall, and the majority of adverse events (AEs) were mild. The most commonly reported AE in the colchicine arm was new or worsened diarrhea, affecting 17% of participants compared with 6% in the placebo group.
The study authors caution that their trial was limited by small participant numbers, and therefore it was not possible to evaluate the impact of colchicine on mortality risk.
They conclude: “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.”
medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2021 Springer Healthcare Ltd, part of the Springer Nature Group
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