Colchicine for the treatment of COVID-19
Mikolajewska A, Fischer AL, Piechotta V, Mueller A, Metzendorf MI, Becker M, Dorando E, Pacheco RL, Martimbianco ALC, Riera R, Skoetz N, Stegemann M. Cochrane Database of Systematic Reviews 2021, No. 10. Art. No.: CD015045. doi: 10.1002 /14651858.CD015045. Accessed November 2, 2021.
Commentary
This will be a study evaluating the efficacy and safety of colchicine as a treatment option for COVID-19 compared to active comparators, placebo, or standard of care alone in any setting. It will use a live systematic review approach to keep the evidence current.
Including three RCTs with 11,525 inpatient participants (8002 men) and one RCT with 4488 non-inpatient participants (2067 men), the mean age of those treated in the hospital was approximately 64 years, compared with 55 years in the study of non-inpatient participants.
Colchicine Plus Standard of Care vs Standard of Care (Plus/Minus Placebo)
Treatment of hospitalized patients with moderate to severe COVID-19
Mortality from all causes: Colchicine plus standard care may result in little or no difference in mortality from all causes up to 28 days compared with standard care alone.
For worsening of clinical status, the combination of colchicine and standard therapy may make little or no difference in worsening of clinical status assessed as a new need for invasive ventilation, death, compared with standard therapy alone.
For improvement in clinical status, the combination of colchicine and standard of care may make little or no difference in improvement in clinical status, as assessed as the number of participants who survive to day 28 and are discharged without clinical deterioration or death, compared with standard of care alone.
With regard to adverse events, the evidence on the effect of colchicine on adverse events compared to placebo is very uncertain.
Treatment of people not hospitalized with asymptomatic SARS-CoV-2 infection or mild COVID-19
For all-cause mortality, the evidence on the effect of colchicine on all-cause mortality at 28 days is uncertain.
For hospitalization and death within 28 days, colchicine probably slightly reduces the need for hospitalization or death within 28 days compared to placebo.
With regard to adverse events, the evidence for an effect of colchicine on adverse events compared to placebo is uncertain.
Colchicine vs. other aggressive therapies (e.g., corticosteroids, antivirals, monoclonal antibodies)
No studies have evaluated this comparison.
Different formulations, doses, or schedules of colchicine
No studies have evaluated this.
