Colchicine may reduce the need for supplemental oxygen therapy and the length of hospitalisation among patients with moderate-to-severe coronavirus disease 2019 (COVID-19), according to a small study published in RMD Open.
From April 11 to August 30, 2020, a total of 72 patients were randomly assigned to receive either colchicine (n = 36) or placebo (n = 36). Colchicine was administered at 0.5 mg thrice daily for 5 days, followed by 0.5 mg twice daily for 5 days. All patients received the institutional protocol treatment with hydroxychloroquine, azithromycin and heparin. Meanwhile, 25 and 24 patients, respectively, in colchicine and placebo groups also received methylprednisolone. Both groups were similar in terms of demographic characteristics, clinical status and laboratory evaluation at baseline.
The researchers found that the median time of need for supplemental oxygen was shorter among patients who received colchicine compared with patients who received placebo (4.0 vs 6.5 days; P<0.001). At day 2, 67% of patients in the colchicine group maintained the need for supplemental oxygen compared to 86% of patients in the placebo group, while at day 7, the proportion of patients requiring supplemental oxygen reduced to 9% in the colchicine group compared to 42% in the the placebo groups (log rank test, 10.6; P = 0.001).
Similarly, a shorter median duration of hospitalisation was observed among patients in the colchicine group compared with those in the placebo group (7.0 vs 9.0 days; P = 0.003). At day 7, 42% of patients who received colchicine remained hospitalised compared to 72% of patients who did not receive colchicine, while at day 10, the proportions of patients who remained hospitalised were 9% and 39%, respectively (log rank test, 9.2; P = 0.002).
In addition, two and four patients, respectively, in the colchicine and placebo group needed admission to ICU. Two patients died, both in the placebo group.
Further, the majority of adverse events were mild (exception for pneumonia) and, to some extent, attributable to the viral infection itself or its complications, not entailing patients withdrawal.
“Patients who received colchicine in this randomised, double-blinded, placebo-controlled clinical trial presented better evolution in terms of the need for supplemental oxygen and the length of hospitalisation,” concluded Maria Isabel Lopes, University of Sao Paulo, Ribeirão Preto, Brazil, and colleagues.
“Colchicine was safe and well tolerated,” the authors added. “Clinical trials with larger numbers of patients should be conducted to further evaluate the efficacy and safety of colchicine as an adjunctive therapy for hospitalised patients with moderate-to-severe COVID-19.”