Colchicine and mortality outcomes in patients with coronavirus disease (COVID-19)

Abstract

One of the therapeutic hallmarks of the ongoing (COVID-19) pandemic has been the different iterations of successful and sometimes unsuccessful attempts at re-purposing of drugs with pre-existing market authorization for use in COVID-19 patients. We therefore read with interest Perricone et al’s., recent report on the clinical outcomes of hospitalized COVID-19 patients exposed to colchicine [1]. This randomized controlled clinical trial (RCT) evaluating efficacy and safety of generic colchicine found no significant difference in the primary composite endpoints of intensive care admissions (ICU) and the need for mechanical ventilation between patients exposed to colchicine added to standard of care (N = 77) vs. controls (N = 75) stabilized on usual standard of care (mechanical ventilation 5.2% vs 4%, ICU 1.3% vs 5.3%, death 9.1% vs. 6.7%, overall 11 (14.3%) vs. 10 (13.3%) patients, P=not significant). Perricone et al’s., report has “arrived” at critical time against a backdrop of ongoing uncertainty regarding the exact relationship between colchicine exposure and hard clinical endpoints in COVID-19 patients. Discordant studies from both observational as well as clinical trials have reported both mortality-reducing propensity of colchicine in these cohorts of patients, as well null effect by others [2].