A cheap drug used to treat gout helps to reduce the need for oxygen therapy among the most ill COVID-19 patients, according to the results of a small clinical trial.
The Brazil study, published in RMD Open, says adding colchicine to standard treatment for hospital patients with moderate to severe COVID-19 infection also reduced in-patient stays.
However, they say it is not possible to confirm if the drug, normally used to treat and prevent systemic inflammatory conditions, can alter the mortality risk.
The research team randomly assigned 75 patients, all of whom were admitted to hospital with moderate to severe COVID-19 between April and August 2020, to receive either standard treatment plus 0.5 mg colchicine three times a day for five days, followed by the same dose twice a day for five days, or standard treatment plus a placebo. Out of the 75 patients, five were within a healthy weight range.
Standard treatment comprised doses of azithromycin, hydroxychloroquine, and heparin, plus methylprednisolone if the need for supplemental oxygen was classed as considerable – equal to six litres/minute or more – and intensive care was required.
The results are based on 72 patients – 36 in each group – and the researchers found the average length of time the patients needed oxygen therapy was four days for those treated with additional colchicines, compared with 6.5 days for those in the standard treatment plus placebo group.
The average length of hospital stay was seven days for patients in the colchicine group and nine for those in the standard treatment group.
By day seven, 9% in the colchicine group needed maintenance oxygen compared with 42% in the standard treatment group. Two patients died, both of whom were in the placebo group.
The researchers say colchicine was safe and well tolerated, and there were few side effects, with diarrhoea being the most common.
They caution that only a small number of patients were included in the trial, and the study was unable to establish if the drug would avoid the need for intensive care or lessen the risk of death.
The researchers also say although colchicine is “very unlikely” to have some direct antiviral properties, it may lessen the body’s inflammatory response and help ward off damage to endothelial cells.
“Whatever the mechanism of action, colchicine seems to be beneficial for the treatment of hospitalised patients with COVID-19,” they write.
Lopes MI, Bonjorno LP, Giannini MC et al. Beneficial effects of colchicine for moderate to severe COVID-19: a randomised, double-blinded, placebo controlled clinical trial. RMD Open. February 2021. doi 10.1136/rmdopen-2020-001455
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