In this episode, I’ll discuss colchicine in patients admitted to hospital with COVID-19.
When steroids like dexamethasone were found effective for COVID-19, it was logical to wonder whether colchicine, with its anti-inflammatory properties, would also help improve outcomes of patients with COVID-19.
The RECOVERY Trial, which is a randomized, controlled, open-label trial, underway at 177 hospitals recently published results of using colchicine in patients admitted to hospital with COVID-19.
Patients received either placebo or colchicine 1 mg oral load followed by 0.5 mg orally 12 hours later and twice daily thereafter for 10 days or until hospital discharge.
If a patient was on a CYP3A4 inhibitor such as diltiazem they could still be enrolled in the trial but the colchicine dose was reduced by 50%. The colchicine dosage was also reduced by 50% for patients under 70 kg or with creatinine clearance under 30 mL/min.
The primary outcome was 28-day mortality. There were over 5000 patients in each group. There was no difference found in 28-day mortality between groups, and there was no difference found in any of the prespecified efficacy secondary endpoints.
This large, randomized controlled trial demonstrates that colchicine does not seem to affect clinically important outcomes in patients hospitalized with COVID-19.
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