COLCHICINE, an anti-inflammatory oral drug commonly used for the treatment of gout and rheumatic diseases, has reportedly been shown to significantly improve coronavirus disease (COVID-19) outcomes in patients with relatively mild symptoms.
Currently, the list of effective outpatient therapies against COVID-19 is limited to convalescent plasma and monoclonal antibodies. Such interventions are often logistically challenging to rollout since they require infusions and must be administered shortly after symptom onset. However, successful and efficient outpatient treatment could greatly reduce both morbidity and mortality as well as the demand for scarce or costly care resources such as ventilators or hospital beds.
COLCORONA was a double-blind, placebo-controlled clinical trial that took place without in-person contact. The study included 4,488 participants across Canada, Europe, South Africa, South America, and the USA to determine whether colchicine could reduce the risk of severe complications associated with COVID-19. Patients included in the trial were aged 40 and older, not hospitalised at the time of enrolment, and had at least one risk factor for COVID-19 complications.
Among the 4,159 patients in whom the diagnosis of COVID-19 was confirmed by a nasopharyngeal PCR test, the use of colchicine was associated with a statistically significant reduction in the risk of death or hospitalisation relative to the control group. In participants with a proven diagnosis, colchicine was found to reduce hospitalisations by 25%, the need for mechanical ventilation by 50%, and deaths by 44%. Based on these research findings, colchicine could potentially function as the world’s first oral drug utilised in the treatment of non-hospitalised patients with COVID-19.
Principal investigator Dr Jean-Claude Tardif, Montreal Heart Institute, Montreal, Canada, commented: “Our research shows the efficacy of colchicine treatment in preventing the ‘cytokine storm’ phenomenon and reducing the complications associated with COVID-19.” Dr Tardif further noted that the use of colchicine could “have a significant impact on public health and potentially prevent COVID-19 complications for millions of patients.”
Despite the initial promise of these results, it is important to note that key details including confidence intervals, adverse effects, and subgroup results were omitted from the press release issued by the Montreal Heart Institute. Until a full manuscript is published, Dr Richard Kovacs (immediate past president of the American College of Cardiology [ACC]) warned: “We don’t know enough to bring this into practice yet.”