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All Studies   Meta Analysis    Recent:   

Colchicine and aspirin in community patients with COVID-19 (ACT): an open-label, factorial, randomised, controlled trial

Eikelboom et al., The Lancet Respiratory Medicine, doi:10.1016/S2213-2600(22)00299-5, ACT outpatient, NCT04324463
Oct 2022  
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Mortality -9% Improvement Relative Risk Death/hospitalization -2% primary Hospitalization -2% Colchicine  ACT outpatient  LATE TREATMENT  RCT Is late treatment with colchicine beneficial for COVID-19? RCT 3,881 patients in Canada (August 2020 - February 2022) No significant difference in outcomes seen c19early.org Eikelboom et al., The Lancet Respirato.., Oct 2022 Favorscolchicine Favorscontrol 0 0.5 1 1.5 2+
Colchicine for COVID-19
5th treatment shown to reduce risk in September 2020
 
*, now with p = 0.00000031 from 56 studies.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,800+ studies for 98 treatments. c19early.org
Late (5.4 days) outpatient RCT showing no significant difference in outcomes with colchicine treatment. Authors include a meta analysis of 6 colchicine RCTs, however there were 19 RCTs as of the publication date1.
Study covers aspirin and colchicine.
risk of death, 9.0% higher, HR 1.09, p = 0.84, treatment 12 of 1,939 (0.6%), control 11 of 1,942 (0.6%).
risk of death/hospitalization, 2.0% higher, HR 1.02, p = 0.93, treatment 66 of 1,939 (3.4%), control 65 of 1,942 (3.3%), primary outcome.
risk of hospitalization, 2.0% higher, HR 1.02, p = 0.92, treatment 62 of 1,939 (3.2%), control 61 of 1,942 (3.1%).
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Eikelboom et al., 10 Oct 2022, Randomized Controlled Trial, Canada, peer-reviewed, mean age 45.0, 31 authors, study period 27 August, 2020 - 10 February, 2022, average treatment delay 5.4 days, dosage 1.2mg days 1-3, 0.6mg days 4-28, trial NCT04324463 (history) (ACT outpatient). Contact: eikelbj@mcmaster.ca.
This PaperColchicineAll
Colchicine and aspirin in community patients with COVID-19 (ACT): an open-label, factorial, randomised, controlled trial
John W Eikelboom, Sanjit S Jolly, Emilie P Belley-Cote, Prof Richard P Whitlock, Sumathy Rangarajan, PhD, S Rangarajan MSc Lizhen Xu, PhD Laura Heenan, Prof S I Shrikant I Bangdiwala, Wadea M Tarhuni, Mohamed Hassany, Anna Kontsevaya, Sanjib William Harper, Sanjib Kumar Sharma, Prof Patricio Lopez-Jaramillo, Antonio L Dans, Prof Lia M Palileo-Villanueva, Alvaro Avezum, Prem Pais, Denis Xavier, Camilo Felix, Afzalhussein Yusufali, Renato D Lopes, Otavio Berwanger, Zeeshan Ali, MD Sean Wasserman, Prof Sonia S Anand, Prof Jackie Bosch, Shurjeel Choudhri, Michael E Farkouh, Mark Loeb, Salim Yusuf
The Lancet Respiratory Medicine, doi:10.1016/s2213-2600(22)00299-5
Background The large number of patients worldwide infected with the SARS-CoV-2 virus has overwhelmed healthcare systems globally. The Anti-Coronavirus Therapies (ACT) outpatient trial aimed to evaluate anti-inflammatory therapy with colchicine and antithrombotic therapy with aspirin for prevention of disease progression in community patients with COVID-19. Methods The ACT outpatient, open-label, 2 × 2 factorial, randomised, controlled trial, was done at 48 clinical sites in 11 countries. Patients in the community aged 30 years and older with symptomatic, laboratory confirmed COVID-19 who were within 7 days of diagnosis and at high risk of disease progression were randomly assigned (1:1) to receive colchicine 0•6 mg twice daily for 3 days and then 0•6 mg once daily for 25 days versus usual care, and in a second (1:1) randomisation to receive aspirin 100 mg once daily for 28 days versus usual care. Investigators and patients were not masked to treatment allocation. The primary outcome was assessed at 45 days in the intention-to-treat population; for the colchicine randomisation it was hospitalisation or death, and for the aspirin randomisation it was major thrombosis, hospitalisation, or death. The ACT outpatient trial is registered at ClinicalTrials.gov, NCT04324463 and is ongoing.
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Late treatment
is less effective
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