New Analysis Finds Gout Drug Colchicine Doesn’t Actually Lessen COVID-19 Severity or Stave Off Risk of Death

Nor does it reduce hospital stays and is associated with a high risk of side effects.

Colchicine, an inexpensive anti-inflammatory drug normally used to treat gout, does not reduce the severity of COVID-19 or prevent the risk of death from the infection in hospitalized patients, finds a pooled analysis of the available evidence, published in the open access magazine RMD Open.

In addition, it is associated with a high risk of side effects, especially diarrhea, the analysis shows.

Early observational studies suggested that colchicine could be a useful adjunct to available treatments for COVID-19 infection, and it has already made its way into clinical practice in some places.

To clarify its safety and effectiveness, the researchers searched research databases looking for relevant comparative clinical trial data on the drug’s use to treat COVID-19 infection, published through July 2021.

The researchers wanted to know whether colchicine reduced the risk of death, the need for ventilators, admission to the intensive care unit, and length of hospital stay; and whether its use was associated with certain side effects.

They applied the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach to assess the quality of the evidence for each of these outcomes.

Observational studies, laboratory studies, animal studies, and studies involving less than 10 participants were all excluded.

Of the 69 full texts reviewed, 6 randomized controlled trials involving 16,148 patients with varying degrees of severity of COVID-19 were included in the pooled data analysis.

This showed that there was no significant reduction in the risk of death (6 studies), the need for ventilation (5 studies), intensive care admission (3 studies), length of hospitalization (4 studies), or serious adverse reactions (3 studies) between patients treated with colchicine and patients who received usual supportive care only.

Patients taking colchicine also had 58% more side effects and nearly double the risk of diarrhea than those receiving supportive care.

GRADE quality of evidence was moderate for most of the outcomes studied.

The researchers caution: “Our findings on colchicine should be interpreted with caution due to the inclusion of open-label randomized clinical trials. The analysis of efficacy and safety results is based on a small number of: [randomized controlled trials] in control interventions.”

But they conclude: “Colchicine does not reduce the risk of death, ventilator support, intensive care admission or length of hospital stay in patients with COVID-19. There is no additional benefit of adding colchicine to supportive care in the management of patients with COVID-19.”

Reference: “Efficacy and safety of colchicine in COVID-19: a meta-analysis of randomized controlled trials” Nov 22, 2021, RMD Open.
DOI: 10.1136/rmdopen-2021-001746