Case Report: Colchicine Toxicokinetic Analysis in a Poisoned Child Requiring Extracorporeal Life Support

Marín, Maria Pérez; Prod’hom, Sylvain; Villiers, Suzanne Francesca de; Ferry, Thomas; Amiet, Vivianne; Natterer, Julia; Perez, Marie-Hélène; Buclin, Thierry; Chtioui, Haïthem; Longchamp, David

doi:10.3389/fped.2021.658347

Cited by 7 publications

(2 citation statements)

References 18 publications

(19 reference statements)

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“…Colchicine has repeatedly been administered in the so‐called loading “overdoses” from 3 to 6.7 mg without any life‐threatening effect. 7 , 16 , 43 , 44 , 45 , 46 , 47 Moreover, in cases of familial Mediterranean fever (FMF) resistance, a colchicine “maximum tolerated dose” is recommended. 43 The effect of high‐dose colchicine in COVID‐19 obese patients 26 , 48 and the effect of accidental colchicine overdoses in a COVID‐19 patients 27 are in line with this opinion.…”

Section: Discussionmentioning

confidence: 99%

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Effect of increasing doses of colchicine on the treatment of 333 COVID‐19 inpatients

Tiholov,

Lilov,

Georgieva

et al. 2024

Immunity Inflam & Disease

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BackgroundPrevious research done in Bulgaria demonstrated a fivefold reduction in mortality from COVID‐19 with increased doses of colchicine from two hospitals in the country. We report here a further 333 cases of COVID‐19 inpatients, treated with different doses of colchicine and its effect on mortality.Materials and MethodsA case‐control comparison from two additional hospitals was conducted between increased doses of colchicine and added bromhexine to standard of care (SOC) versus current SOC. Risk and odds ratio, as well as subgroup analysis, was conducted with newly reported data, alongside aggregate data from all hospital centers to determine the extent of mortality reduction in COVID‐19 inpatients.ResultsThere was a clear reduction in the mortality of inpatients with increasing doses of colchicine—between twofold and sevenfold. Colchicine loading doses of 4 mg are more effective than those with 2 mg. Despite these doses being higher than the so‐called “standard doses,” colchicine inpatients experienced lower mortality than SOC patients (5.7% vs. 19.53%). This mortality benefit was evident in different age subgroups, with a 4‐mg loading dose of colchicine proving slightly superior to a 2‐mg loading dose. Colchicine led to an overall relative risk reduction of 70.7%, with SOC patients having 3.91 higher odds of death. The safety of the doses was not different than the reported in the summary of product characteristics.ConclusionInpatients in Bulgaria with added colchicine and bromhexine to SOC achieved better clinical and mortality outcomes than those on SOC alone. These results question the World Health Organization—recommended strategy to inhibit viral replication. We posit that our treatment strategy to inhibit the Severe acute respiratory syndrome coronavirus 2 entry into the cell with inhaled bromhexine and the hyperactivated NLRP3 inflammasome with higher doses of colchicine, prevents the development of cytokine storm. The timing of the initiation of treatment seems critical.

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Section: Discussionmentioning

confidence: 99%

“…Colchicine has repeatedly been administered in the so‐called loading “overdoses” from 3 to 6.7 mg without any life‐threatening effect 7,16,43–47 . Moreover, in cases of familial Mediterranean fever (FMF) resistance, a colchicine “maximum tolerated dose” is recommended 43 .…”

Section: Discussionmentioning

confidence: 99%