Colchicine for COVID-19: real-time analysis of all 12 studies

Colchicine for COVID-19 in adults in the community (PRINCIPLE): a randomised, controlled, adaptive platform trial

Dorward et al., medRxiv, doi:2021.09.20.21263828 (Preprint)

Late treatment RCT with 156 colchicine patients in the UK, showing no significant differences. ISRCTN86534580.

risk of death/hospitalization, 29.8% higher, RR 1.30, p = 0.66, treatment 6 of 156 (3.8%), control 4 of 133 (3.0%), OR converted to RR, concurrent randomisation.

risk of death/hospitalization, 22.1% lower, RR 0.78, p = 0.59, treatment 6 of 156 (3.8%), control 119 of 1,145 (10.4%), NNT 15, OR converted to RR, including control patients before the colchicine arm started.

risk of progression, 6.0% lower, RR 0.94, p = 0.45, treatment 102 of 156 (65.4%), control 83 of 120 (69.2%), NNT 26.

risk of no recovery, 6.0% lower, RR 0.94, p = 0.67, treatment 156, control 133, time to alleviation of symptoms.

Dorward et al., 9/23/2021, Randomized Controlled Trial, United Kingdom, Europe, preprint, 21 authors.

Effectiveness of Rosuvastatin plus Colchicine, Emtricitabine/Tenofovir and a combination of them in Hospitalized Patients with SARS Covid-19

Gaitán-Duarte et al., medRxiv, doi:10.1101/2021.07.06.21260085 (Preprint)

RCT 633 hospitalized patients in Colombia, 153 treated with colchicine + rosuvastatin, not showing statistically significant differences in outcomes. Improved results were seen with the combination of emtricitabine/tenofovir disoproxil + rosuvastatin + colchicine. NCT04359095.

risk of death, 19.0% lower, RR 0.81, p = 0.43, treatment 22 of 153 (14.4%), control 28 of 161 (17.4%), NNT 33, adjusted, 28 days.

risk of mechanical ventilation, 15.0% lower, RR 0.85, p = 0.15, treatment 27 of 136 (19.9%), control 27 of 140 (19.3%), adjusted.

risk of ICU admission, 1.0% lower, RR 0.99, p = 0.97, treatment 19 of 113 (16.8%), control 18 of 114 (15.8%), adjusted.

Gaitán-Duarte et al., 7/10/2021, Randomized Controlled Trial, Colombia, South America, preprint, 17 authors, this trial uses multiple treatments in the treatment arm (combined with rosuvastatin) - results of individual treatments may vary.

Colchicine in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Recovery Collaborative Group, The Lancet Respiratory Medicine, doi:10.1016/S2213-2600(21)00435-5 (preprint 5/18/2021) (Peer Reviewed)

RCT with 5,610 colchicine and 5,730 control patients showing mortality RR 1.01 [0.93-1.10]. Very late stage treatment, mean 9 days after symptom onset. Baseline oxygen requirements unknown (data is provided but combined with "none"). ISRCTN 50189673. NCT04381936.

risk of death, 1.0% higher, RR 1.01, p = 0.77, treatment 1,173 of 5,610 (20.9%), control 1,190 of 5,730 (20.8%).

risk of mechanical ventilation, 18.0% higher, RR 1.18, p = 0.06, treatment 259 of 3,815 (6.8%), control 228 of 3,962 (5.8%).

risk of death/intubation, 2.0% higher, RR 1.02, p = 0.47, treatment 1,344 of 5,342 (25.2%), control 1,343 of 5,469 (24.6%).

risk of no hospital discharge, 2.0% higher, RR 1.02, p = 0.44, treatment 1,709 of 5,610 (30.5%), control 1,698 of 5,730 (29.6%).

Recovery Collaborative Group et al., 5/18/2021, Randomized Controlled Trial, United Kingdom, Europe, peer-reviewed, 35 authors.

Colchicine treatment can improve outcomes of coronavirus disease 2019 (COVID‐19): A systematic review and meta‐analysis

Hariyanto et al., Clinical and Experimental Pharmacology and Physiology, doi:10.1111/1440-1681.13488 (Peer Reviewed) (meta analysis)

Meta analysis concluding that colchicine can reduce severity and mortality in COVID‐19 patients, mortality OR 0.43 [0.32-0.58].

Hariyanto et al., 3/14/2021, peer-reviewed, 5 authors.

Colchicine for community-treated patients with COVID-19 (COLCORONA): a phase 3, randomised, double-blinded, adaptive, placebo-controlled, multicentre trial

Tardif et al., The Lancet Respiratory Medicine, doi:10.1016/S2213-2600(21)00222-8 (preprint 1/27) (Peer Reviewed)

RCT for relatively low risk outpatients, 2235 treated with colchicine a mean of 5.3 days after the onset of symptoms, and 2253 controls, showing lower mortality, ventilation, and hospitalization with treatment. NCT04322682.

risk of death, 43.9% lower, RR 0.56, p = 0.30, treatment 5 of 2,235 (0.2%), control 9 of 2,253 (0.4%), NNT 569, OR converted to RR.

risk of mechanical ventilation, 46.8% lower, RR 0.53, p = 0.09, treatment 11 of 2,235 (0.5%), control 21 of 2,253 (0.9%), NNT 227, OR converted to RR.

risk of hospitalization, 20.0% lower, RR 0.80, p = 0.09, treatment 101 of 2,235 (4.5%), control 128 of 2,253 (5.7%), NNT 86, OR converted to RR.

Tardif et al., 1/27/2021, Double Blind Randomized Controlled Trial, Canada, North America, peer-reviewed, 44 authors.

Clinical characteristics and risk factors for mortality of hospitalized patients with COVID-19 in a community hospital: A retrospective cohort study

Rodriguez-Nava et al., Mayo Clinic Proceedings: Innovations, Quality & Outcomes (Peer Reviewed)

Retrospective 313 patients, mostly critical stage and mostly requiring respiratory support. Confounding by indication likely.

risk of death, 5.5% lower, RR 0.94, p = 0.87, treatment 16 of 52 (30.8%), control 85 of 261 (32.6%), NNT 56, unadjusted.

Excluded in after exclusion results of meta analysis: substantial unadjusted confounding by indication likely, excessive unadjusted differences between groups, unadjusted results with no group details.

Rodriguez-Nava et al., 11/5/2020, retrospective, USA, North America, peer-reviewed, median age 68.0, 8 authors.

A Case Control Study to Evaluate the Impact of Colchicine on Patients Admitted to the Hospital with Moderate to Severe COVID-19 Infection

Sandhu et al., Canadian Journal of Infectious Diseases and Medical Microbiology, doi:10.1155/2020/8865954 (Peer Reviewed)

Prospective cohort study of hospitalized patients in the USA, 34 treated with colchicine, showing lower mortality and intubation with treatment.

risk of death, 41.7% lower, RR 0.58, p < 0.001, treatment 16 of 34 (47.1%), control 63 of 78 (80.8%), NNT 3.0.

risk of mechanical ventilation, 52.9% lower, RR 0.47, p < 0.001, treatment 16 of 34 (47.1%), control 68 of 68 (100.0%), NNT 1.9.

risk of no hospital discharge, 41.7% lower, RR 0.58, p < 0.001, treatment 16 of 34 (47.1%), control 63 of 78 (80.8%), NNT 3.0.

hospitalization time, 4.5% lower, relative time 0.95, treatment 34, control 78.

Sandhu et al., 10/27/2020, prospective, USA, North America, peer-reviewed, 4 authors.

Clinical Outcome of Patients with COVID-19 Pneumonia Treated with Corticosteroids and Colchicine in Colombia

Pinzón et al., Research Square, doi:10.21203/rs.3.rs-94922/v1 (Preprint)

Retrospective 301 pneumonia patients in Colombia showing lower mortality with colchicine treatment.

risk of death, 34.5% lower, RR 0.65, p = 0.18, treatment 14 of 145 (9.7%), control 23 of 156 (14.7%), NNT 20, OR converted to RR.

Pinzón et al., 10/23/2020, retrospective, Colombia, South America, preprint, 9 authors.

The Impact of Colchicine on The COVID-19 Patients; A Clinical Trial Study

Salehzadeh et al., Research Square, doi:10.21203/rs.3.rs-69374/v1 (Preprint)

Open label RCT with 100 hospitalized patients in Iran, 50 treated with colchicine, showing shorter hospitalization time. There were no deaths. IRCT20200418047126N1.

hospitalization time, 22.7% lower, relative time 0.77, p = 0.001, treatment 50, control 50.

Salehzadeh et al., 9/21/2020, Randomized Controlled Trial, Iran, Middle East, preprint, 3 authors.

Association between treatment with colchicine and improved survival in a single-centre cohort of adult hospitalised patients with COVID-19 pneumonia and acute respiratory distress syndrome

Scarsi et al., Annals of the Rheumatic Diseases, doi:10.1136/annrheumdis-2020-217712 (Peer Reviewed)

Retrospective 122 colchicine patients and 140 control patients in Italy, showing lower mortality with treatment.

risk of death, 84.9% lower, RR 0.15, p < 0.001, treatment 122, control 140.

Scarsi et al., 9/14/2020, retrospective, Italy, Europe, peer-reviewed, 28 authors.

Colchicine to Weather the Cytokine Storm in Hospitalized Patients with COVID-19

Brunetti et al., J. Clin. Med., 9:9, 2961, doi:10.3390/jcm9092961 (Peer Reviewed)

PSM matched analysis from consecutive hospitalized patients, with 33 colchicine and 33 control matched patients, showing lower mortality with treatment.

risk of death, 72.7% lower, RR 0.27, p = 0.03, treatment 3 of 33 (9.1%), control 11 of 33 (33.3%), NNT 4.1, PSM.

risk of no hospital discharge, 72.7% lower, RR 0.27, p = 0.03, treatment 3 of 33 (9.1%), control 11 of 33 (33.3%), NNT 4.1, PSM.

Brunetti et al., 9/14/2020, retrospective, propensity score matching, USA, North America, peer-reviewed, 7 authors.

Beneficial effects of colchicine for moderate to severe COVID-19: a randomised, double-blinded, placebo-controlled clinical trial

Lopes et al., RMD Open, doi:10.1136/rmdopen-2020-001455 (preprint 8/12) (Peer Reviewed)

RCT with 36 colchicine and 36 control patients, showing reduced length of hospitalization and oxygen therapy with treatment.

risk of death, 80.0% lower, RR 0.20, p = 0.49, treatment 0 of 36 (0.0%), control 2 of 36 (5.6%), NNT 18, relative risk is not 0 because of continuity correction due to zero events.

risk of ICU admission, 50.0% lower, RR 0.50, p = 0.67, treatment 2 of 36 (5.6%), control 4 of 36 (11.1%), NNT 18.

oxygen time, 38.5% lower, relative time 0.62, treatment 36, control 36.

hospitalization time, 22.2% lower, relative time 0.78, treatment 36, control 361.

Lopes et al., 8/12/2020, Double Blind Randomized Controlled Trial, Brazil, South America, peer-reviewed, 34 authors.

Effect of Colchicine vs Standard Care on Cardiac and Inflammatory Biomarkers and Clinical Outcomes in Patients Hospitalized With Coronavirus Disease 2019: The GRECCO-19 Randomized Clinical Trial

Deftereos et al., JAMA Network Open, doi:10.1001/jamanetworkopen.2020.13136 (Peer Reviewed)

RCT with 55 patients treated with colchicine and 50 control patients, showing lower mortality and ventilation with treatment. NCT04326790.

risk of death, 77.3% lower, RR 0.23, p = 0.19, treatment 1 of 55 (1.8%), control 4 of 50 (8.0%), NNT 16.

risk of mechanical ventilation, 81.8% lower, RR 0.18, p = 0.10, treatment 1 of 55 (1.8%), control 5 of 50 (10.0%), NNT 12.

risk of clinical deterioration, 87.4% lower, RR 0.13, p = 0.05, treatment 1 of 55 (1.8%), control 7 of 50 (14.0%), NNT 8.2, OR converted to RR.

Deftereos et al., 6/24/2020, Randomized Controlled Trial, Greece, Europe, peer-reviewed, 49 authors.

Antiandrogens	(meta)	Metformin	(meta)
Aspirin	(meta)	Molnupiravir	(meta)
Bamlanivimab	(meta)	Nigella Sativa	(meta)
Bromhexine	(meta)	Nitazoxanide	(meta)
Budesonide	(meta)	Paxlovid	(meta)
Casirivimab/i..	(meta)	Povidone-Iod..	(meta)
Colchicine	(meta)	Probiotics	(meta)
Conv. Plasma	(meta)	Proxalutamide	(meta)
Curcumin	(meta)	Quercetin	(meta)
Favipiravir	(meta)	Remdesivir	(meta)
Fluvoxamine	(meta)	Sotrovimab	(meta)
Hydroxychlor..	(meta)	Vitamin A	(meta)
Iota-carragee..	(meta)	Vitamin C	(meta)
Ivermectin	(meta)	Vitamin D	(meta)
Melatonin	(meta)	Zinc	(meta)

Other Treatments		Global Adoption