Colchicine fails to reduce COVID-19 severity, risk for death
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Adding colchicine to the standard care regimen for COVID-19 fails to decrease disease severity or reduce the risk for death in hospitalized patients, according to a meta-analysis published in RMD Open.
“Colchicine is an anti-inflammatory drug prescribed in many inflammatory diseases [such as] gout, familial Mediterranean fever and pericarditis,” Kedar Gautambhai Mehta, MD (PSM), CIH, CNM, DMCH, PGQMAHO, of GMERS Medical College Gotri, in Vadodara, India, told Healio Rheumatology. “Colchicine is prescribed nowadays for COVID-19. Previous research studies have concluded that colchicine is effective in reducing mortality among COVID-19 patients.”
To examine the efficacy and safety of colchicine in patients with COVID-19, Mehta and colleagues conducted a meta-analysis of six randomized controlled studies, totaling 16,148 participants. According to the researchers, the studies evaluated the efficacy and/or safety of colchicine compared with supportive care for patients with COVID-19. Efficacy outcomes included mortality, ventilatory support, ICU admission and length of hospital stay. Safety outcomes were adverse events, serious adverse events and diarrhea.
The researchers performed a meta-analytical summary using a random effects model through the Mantle-Hanzle method. In addition, they used an I2 test to analyze heterogeneity, as well as the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach to examine the quality of evidence for each outcome.
According to the researchers, patients who received colchicine failed to demonstrate a significant reduction in mortality (RD = –0; 95% CI, –0.01 to 0.01; I 2= 15%), ventilatory support (RR = 0.67; 95% CI, 0.38-1.21; I2 = 47%), ICU admission (RR = 0.49; 95% CI, 0.19-1.25; I2 = 34%), length of hospital stay (mean difference = –1.17; 95% CI, –3.02 to 0.67; I2 = 77%) or serious adverse events (RD = –0.01; 95% CI, –0.02 to 0; I2 = 28%), compared with supportive care only.
In addition, patients who received colchicine had higher rates of adverse events (RR = 1.58; 95% CI, 1.07-2.33; I2 = 81%) and diarrhea (RR = 1.93; 95% CI, 1.62-2.29; I2 = 0%), compared with supportive care only. GRADE quality was moderate for most outcomes.
“Based on our findings, there is no additional benefit of adding colchicine to supportive care in management of COVID-19 patients,” Mehta said. “Colchicine does not reduce mortality, need for ventilatory support and ICU admission or length of hospital stay in COVID-19 patients.”
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