Colchicine, a cheap drug commonly used to treat gout, helps cut down the need for oxygen therapy and hospital stays in COVID-19 patients, reveals the results of a small clinical trial , published in the online journal Open RMD.
The findings encourage the researchers from Brazil to suggest that while it is not possible to determine whether colchicine can alter the risk of death, it may be worthwhile to add it to routine treatment for hospitalized patients with the disease. moderate to high COVID-19.
Colchicine has been used successfully to treat and prevent systemic inflammatory conditions, including gout; systemic inflammation is a cardinal feature of moderate to severe COVID-19 disease.
The researchers therefore wanted to find out whether adding to routine treatment would reduce the need for extra oxygen, long-term hospital stays, including intensive care, and the risk of death in hospital. patients with moderate to severe COVID-19 infection.
Moderate disease has been defined as fever, respiratory problems, and pneumonia; severe disease was defined as all of the above, as well as a rapid respiration rate of 30 or more times per minute and low levels of oxygen in the body (oxygen saturation of 92% or less).
Between April and August 2020, they randomly assigned 75 hospitalized patients with moderate to severe COVID-19 infection to either routine treatment plus 0.5 mg of colchicine three times daily for 5 days, and then the same dose twice daily for 5 days, or standard treatment plus dummy drug (placebo).
Routine treatment included doses of the antibiotic azithromycin, the antimalarial hydroxychloroquine, and the blood thinner heparin, as well as a steroid (methylprednisolone) if additional oxygen was required – equivalent to 6 liters / minute or more – and intensive care was required.
Only five patients were within a healthy weight range: obesity and obesity are recognized as risk factors for more severe COVID-19 infection.
The results are based on 72 patients (36 in each group). The average time that patients required oxygen therapy was 4 days for those treated with additional colchicine compared with 6.5 days for those in the usual treatment group plus placebo.
Similarly, the average length of hospital stay was 7 days for the colchicine group compared with 9 for the usual treatment group.
By day 7, less than 1 in 10 (9%) of those treated with colchicine required oxygen maintenance compared with more than 4 in 10 (42%), in the treatment group normal.
Two patients died, and both were in the placebo group. Overall, colchicine was safe and well tolerated, with few side effects; diarrhea was more common in those taking colchicine.
The researchers warn that very few patients were included in the trial, and were unable to determine whether colchicine could avoid the need for intensive care or the risk of death. reduce.
It is not entirely clear how the drug may help fight COVID-19 infection. Colchicine is “very unlikely” to have some direct antiviral properties, but it may reduce the body’s inflammatory response and help prevent damage to the cells in it. vessel walls (endothelial cells), they suggest.
“Whatever the mode of action …– colchicine appears to be beneficial for the treatment of hospitalized patients with COVID-19,” they write, adding that it was not associated with side effects, such as heart or liver damage or boosting the immune system – side effects that are sometimes linked to some of the other drugs used to treat the disease.
Reductions in the need for oxygen treatment and length of stay in hospital are not only good for patients but will cut health care costs and the need for hospital beds, as well as colchicine not being an expensive drug, they are decision.
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External peer review? Yes
Type of evidence: Randomized controlled trial
Subjects: People
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