Infectious Disease

Colchicine fails to reduce mechanical ventilation and 28-day mortality in COVID-19 pneumonia

January 12, 2022

2 minutes read

Source / information

Published by:

Healio rheumatology logo

Disclosure:
This study was funded by the Population Health Research Institute and Fundacion ECLA. Bhatt reports grants from Amarin, AstraZeneca, Forest Laboratories, Bristol Myers Squibb, Eisai, Ethicon, Medtronic, Sanofi Aventis, The Medicines Company, Roche, Pfizer, Ischemix, Cardax, Amgen, Eli Lilly & Co., Chiesi, Ironwood, PhaseBio , Idorsia, Synaptic, Abbott, Regeneron, Novo Nordisk, Fractyl, Cereno Scientific, Afimmune, Ferring Pharmaceuticals, Contego Medical, CellProthera, Lexicon, MyoKardia, Owkin, HLS Therapeutics, Janssen, 89Bio, Garmin, PLxPharma and Novartis; personal fees from Duke Clinical Research Institute, Mayo Clinic, Population Health Research Institute, American College of Cardiology, Belvoir Publications, Slack Publications, WebMD, Elsevier, Society of Cardiovascular Patient Care, HMP Global, Harvard Clinical Research Institute, the Journal of the American College of Cardiology, American Heart Association, Cleveland Clinic, Mount Sinai School of Medicine, TobeSoft, Boehringer Ingelheim, Bayer, Medtelligence/ReachMD, CSL Behring, MJH Life Sciences, Level Ex, K2P, and Canadian Medical and Surgical Knowledge Translation Research Group; Served as a site co-investigator for Abbott, Biotronik, Boston Scientific, CSI, St. Jude Medical, Philips and Svelte; conducting unfunded research for FlowCo, Merck and Takeda; member of an advisory board for Medscape Cardiology and Regado Biosciences; as Associate Editor for Clinical Cardiology and on the Publications Committee of the VA CART Research and Publications Committee; and a member of the board of directors of the Boston VA Research Institute. The relevant financial information of all other authors can be found in the study.

ADD SUBJECT TO EMAIL ALERTS

Receive an email when new articles are published on

Please enter your email address to receive an email when new articles are published on . “data-action =” subscribe “> subscribe

We could not process your request. Please try again later. If this problem persists, please contact [email protected].

Back to Healio

According to data published in JAMA Network Open, colchicine fails to significantly reduce mechanical ventilation or 28-day mortality in hospitalized patients with COVID-19 pneumonia compared to usual care.

“Colchicine is a relatively safe and inexpensive anti-inflammatory drug in most parts of the world that doctors everywhere are familiar with.” Deepak L. Bhatt, MD, MPH, FACC, FAHA, FSCAI, FESC, of Brigham and Women’s Hospital and Harvard Medical School in Boston, across from Healio. “These properties of colchicine led to this study of patients hospitalized with COVID-19. If it had been positive, it would have been an easy therapy for COVID to implement.”

RH0122Diaz_Graphic_01

According to data from Diaz R, et al. Colchicine may not significantly reduce mechanical ventilation or 28-day mortality in hospitalized patients with COVID-19 pneumonia compared to usual care. JAMA network open. 2021;doi:10.1001/jamanetworkopen.2021.41328.

To analyze the efficacy of colchicine in hospitalized patients with COVID-19 pneumonia, Bhatt and colleagues conducted the COLOCOVID study, a multi-center, open-label, randomized clinical trial. A total of 1,279 adults hospitalized with confirmed or suspected COVID-19 — with severe acute respiratory syndrome characterized by shortness of breath or typical or atypical pneumonia on imaging or oxygen desaturation — were randomized 1:1 to receive usual care or usual care plus colchicine to get .

Patients with clear indications or contraindications for colchicine, chronic kidney disease, or a negative reverse transcriptase polymerase chain reaction test for COVID-19 prior to randomization were excluded. A total of 639 patients were assigned to the usual treatment group, while 640 patients received colchicine. Corticosteroids were used in 1,171 participants, or 91.5% of the total study population.

Bhatt_Deepak_2022

Deepak L. Bhatt

Colchicine was administered orally in a 1.5 mg loading dose immediately after randomization, followed by a 0.5 mg dose within 2 hours of the initial dose and additional 0.5 mg doses twice daily for 14 days or discharge . The study was conducted from April 17, 2020 to March 28, 2021. Participants were followed for 28 days, with analysis conducted from June 20, 2021 to July 25, 2021 for 28 days, with death at 28 days serving as the second co-primary outcome.

According to the researchers, 25% of patients in the colchicine group experienced mechanical ventilation or 28-day death compared with 28.8% in the usual care group (HR=0.83; 95% CI, 0.67-1.02). Meanwhile, the second co-primary outcome, death at 28 days, occurred in 20.5% of those receiving colchicine compared with 22.2% of those receiving usual care (HR = 0.88; 95% CI, 0. 7-1:12). Diarrhea was the most common side effect of colchicine, reported in 11.3% of patients in the group.

“The data from this study do not show a significant benefit of colchicine in COVID-19 patients, and the drug should not be used for this purpose at this time without further larger, definitive randomized trials showing a clear benefit,” Bhatt said .

“There seemed to be a possible signal of a modest benefit that would need to be confirmed in a larger, appropriately sized study with either colchicine or perhaps other drugs with anti-inflammatory effects, but repurposed for possible use in COVID-19.” 19 patients,” he added. “Hopefully such studies will take place, but finding funding to conduct studies large enough to be definitive can be difficult.”

ADD SUBJECT TO EMAIL ALERTS

Receive an email when new articles are published on

Please enter your email address to receive an email when new articles are published on . “data-action =” subscribe “> subscribe

We could not process your request. Please try again later. If this problem persists, please contact [email protected].

Back to Healio

COVID-19 and Rheumatology

COVID-19 and Rheumatology

Related Articles