Effect of colchicine on the outcomes of patients with COVID-19: a systematic review and meta-analysis of randomised controlled trials

Abstract

Aim This meta-analysis aimed to assess the usefulness of colchicine in patients with COVID-19. Methods PubMed, Web of Science, Ovid MEDLINE, the Cochrane Library, Embase, and Clinicaltrials.gov were searched for relevant randomised controlled trials (RCTs) published between database inception and November 12, 2021. Only RCTs that compared the clinical efficacy and safety of colchicine with other alternative treatments or placebos in patients with COVID-19 were included. Results Overall, 7 RCTs involving 16,024 patients were included; 7,794 patients were in the study group receiving colchicine and 8,230 were in the control group receiving placebo or standard treatment. The study and control groups had similar risk of mortality (odds ratio [OR], 1.00; 95% CI, 0.91–1.09; I 2 = 0%). No significant difference was observed between the study and control groups in terms of the need for non-invasive ventilation (OR, 0.92; 95% CI, 0.83–1.03; I 2 = 0%), the need for mechanical ventilation (OR, 0.64; 95% CI, 0.32–1.32; I 2 = 58%), and length of hospital stay (mean difference, −0.42 days; 95% CI, −1.95 to 1.11; I 2 = 62%). In addition, colchicine was associated with significantly higher risks of gastrointestinal adverse events (OR, 1.81; 95% CI, 1.56–2.11; I 2 = 0%) and diarrhoea (OR, 2.12; 95% CI, 1.75–2.56; I 2 = 9%). Conclusions Colchicine does not improve clinical outcomes in patients with COVID-19, so it did not support the additional use of colchicine in the treatment of patients with COVID-19. Key message Colchicine could not reduce the mortality of patients with COVID-19. No significant difference was observed between the colchicine and comparators in terms of the need for non-invasive ventilation, need for mechanical ventilation, and length of hospital stay. Colchicine was associated with a higher risk of gastrointestinal adverse events.

Treatment with COLchicine in hospitalized patients affected by COVID-19: The COLVID-19 trial

“…We have confirmed that older age represents a significant adverse prognostic factor in the disease course and on final outcomes both in patients treated with colchicine and in those treated with SOC ( 42 ). We observed that age above 60 years was a significant predictor of not achieving hospital discharge at 30 days and that patients who died had all more than 73 years.…”

Efficacy and safety of nitazoxanide in treating SARS-CoV-2 infection: a systematic review and meta-analysis of blinded, placebo-controlled, randomized clinical trials

“…Several drug repurposing strategies have been evaluated for the prevention and treatment of COVID-19. However, meta-analyses of clinical trials have shown that some of these promising drugs, including hydroxychloroquine [ 8 ], ivermectin [ 9 , 28 ], colchicine [ 29 ], and statins [ 30 ] have no clinical benefits against the disease. This systematic review and meta-analysis synthesized the evidence on the efficacy and safety of nitazoxanide as a potential treatment of patients with COVID-19 based on the results of blinded, placebo-controlled, RCTs.…”

Colchicine reduces the activation of NLRP3 inflammasome in COVID-19 patients

“…The beneficial effects seemed to occur within the first 72 h, concurrently with a significant reduction in serum CRP. Although our and other groups have found beneficial effects of colchicine in COVID-19 patients, a greater number of studies failed to demonstrate a reduction in hospitalization, intensive care unit admission, or mortality, as reviewed in meta-analyses [9][10][11], which concluded that colchicine is not beneficial for treatment in outpatient and inpatient settings. Hence, colchicine is currently not indicated for COVID-19 [12][13][14].…”