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0 0.5 1 1.5 2+ Mortality 29% Improvement Relative Risk Ventilation 50% ICU admission 21% Combined NIV/ICU/ventila.. 15% primary Colchicine  Cecconi et al.  LATE TREATMENT  DB RCT Is late treatment with colchicine beneficial for COVID-19? Double-blind RCT 240 patients in Spain (August 2020 - March 2021) Lower ventilation with colchicine (not stat. sig., p=0.29) Cecconi et al., Scientific Reports, Jun 2022 Favors colchicine Favors control

Efficacy of short-course colchicine treatment in hospitalized patients with moderate to severe COVID-19 pneumonia and hyperinflammation: a randomized clinical trial

Cecconi et al., Scientific Reports, doi:10.1038/s41598-022-13424-6
Jun 2022  
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Colchicine for COVID-19
5th treatment shown to reduce risk in September 2020
*, now known with p = 0.00000018 from 53 studies.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,000+ studies for 60+ treatments.
RCT 240 hospitalized patients with COVID-19 pneumonia, mean 9 days from the onset of symptoms, showing no significant differences with colchicine treatment. EudraCT 2020-001841-38.
Although the 29% lower mortality is not statistically significant, it is consistent with the significant 29% lower mortality [19‑39%] from meta analysis of the 42 mortality results to date.
risk of death, 29.4% lower, RR 0.71, p = 0.62, treatment 7 of 119 (5.9%), control 10 of 120 (8.3%), NNT 41.
risk of mechanical ventilation, 49.6% lower, RR 0.50, p = 0.29, treatment 5 of 119 (4.2%), control 10 of 120 (8.3%), NNT 24.
risk of ICU admission, 20.8% lower, RR 0.79, p = 0.67, treatment 11 of 119 (9.2%), control 14 of 120 (11.7%), NNT 41.
combined NIV/ICU/ventilation/death, 15.3% lower, RR 0.85, p = 0.62, treatment 21 of 119 (17.6%), control 25 of 120 (20.8%), NNT 31, primary outcome.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Cecconi et al., 2 Jun 2022, Double Blind Randomized Controlled Trial, placebo-controlled, Spain, peer-reviewed, mean age 65.0, 31 authors, study period August 2020 - March 2021, average treatment delay 9.0 days, dosage 1mg day 1, 0.5mg days 2-5. Contact:
This PaperColchicineAll
Efficacy of short-course colchicine treatment in hospitalized patients with moderate to severe COVID-19 pneumonia and hyperinflammation: a randomized clinical trial
Alberto Cecconi, Pablo Martinez-Vives, Alberto Vera, Cristina Lavilla Olleros, Ana Barrios, Eva Fonseca Aizpuru, Pilar Roquero, Susana Hernandez Muñiz, Maria Jose Olivera, Marianela Ciudad, Ruben Pampin Sanchez, Rosa Fernandez-Madera Martínez, Azucena Bautista-Hernández, Elena García Castillo, Gorane Iturricastillo, Elena Ávalos, Diana Prada Cotado, Alvaro Alejandre De Oña, Eduardo Fernandez Carracedo, Ana Marcos-Jimenez, Ancor Sanz-Garcia, Aranzazu Alfranca, Maurizio Cecconi, Hortensia De La Fuente, Maria Angeles Sanz De Benito, Paloma Caballero, Francisco Sanchez-Madrid, Julio Ancochea, Carmen Suarez, Luis Jesus Jimenez-Borreguero, Fernando Alfonso
Scientific Reports, doi:10.1038/s41598-022-13424-6
Some patients with COVID-19 pneumonia develop an associated cytokine storm syndrome that aggravates the pulmonary disease. These patients may benefit of anti-inflammatory treatment. The role of colchicine in hospitalized patients with COVID-19 pneumonia and established hyperinflammation remains unexplored. In a prospective, randomized controlled, observer-blinded endpoint, investigator-initiated trial, 240 hospitalized patients with COVID-19 pneumonia and established hyperinflammation were randomly allocated to receive oral colchicine or not. The primary efficacy outcome measure was a composite of non-invasive mechanical ventilation (CPAP or BiPAP), admission to the intensive care unit, invasive mechanical ventilation requirement or death. The composite primary outcome occurred in 19.3% of the total study population. The composite primary outcome was similar in the two arms (17% in colchicine group vs. 20.8% in the control group; p = 0.533) and the same applied to each of its individual components. Most patients received steroids (98%) and heparin (99%), with similar doses in both groups. In this trial, including adult patients with COVID-19 pneumonia and associated hyperinflammation, no clinical benefit was observed with short-course colchicine treatment beyond standard care regarding the combined outcome measurement of CPAP/ BiPAP use, ICU admission, invasive mechanical ventilation or death (Funded by the Community of Madrid, EudraCT Number: 2020-001841-38; 26/04/2020).
Author contributions Competing interests The authors declare no competing interests.
Cai, Obesity and COVID-19 severity in a designated hospital in Shenzhen, China, Diabetes Care
Cecconi, Effects of colchicine on atherosclerotic plaque stabilization: A multimodality imaging study in an animal model, J. Cardiovasc. Transl. Res
Chen, Quach, COVID-19 cytokine storm syndrome: A threshold concept, Lancet Microbe
Cozzi, Chest X-ray in new coronavirus disease 2019 (COVID-19) infection: Findings and correlation with clinical outcome, Radiol. Med
Deftereos, 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, JAMA Netw. Open
Demidowich, Effects of colchicine in adults with metabolic syndrome: A pilot randomized controlled trial, Diabetes Obes. Metab
Diaz, Effect of colchicine vs usual care alone on intubation and 28-day mortality in patients hospitalized with COVID-19: A randomized clinical trial, JAMA Netw. Open
Gao, Associations between body-mass index and COVID-19 severity in 6•9 million people in England: A prospective, community-based, cohort study, Lancet Diabetes Endocrinol
Guo, Cardiovascular implications of fatal outcomes of patients with coronavirus disease 2019 (COVID-19), JAMA Cardiol
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Katz, Regardless of age, obesity and hypertension increase risks with COVID-19, JAMA Intern. Med
Leung, Yao Hui, Kraus, Colchicine-update on mechanisms of action and therapeutic uses, Semin. Arthritis Rheum
Lopes, Beneficial effects of colchicine for moderate to severe COVID-19: A randomised, double-blinded, placebocontrolled clinical trial, RMD Open
Peckham, Male sex identified by global COVID-19 meta-analysis as a risk factor for death and ITU admission, Nat. Commun
Reyes, Anti-inflammatory therapy for COVID-19 infection: The case for colchicine, Ann. Rheum. Dis
Roubille, Tardif, Colchicine for secondary cardiovascular prevention in coronary disease, Circulation
Salamanca, COVID-19 "fulminant myocarditis" successfully treated with temporary mechanical circulatory support, JACC Cardiovas. Imaging
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Tardif, Efficacy and safety of low-dose colchicine after myocardial infarction, N. Engl. J. Med
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Late treatment
is less effective
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