With input from Dr Monica Vasudev

Previous findings of CMAAO suggesting that colchicine is anti-inflammatory have been reconfirmed.

Some salient drugs beneficial in patients with rapidly rising CRP include:

1. The oral, anti-inflammatory drug colchicine can prevent complications and hospitalizations in patients newly diagnosed with COVID-19, according to ColCORONA trial investigators.
2. After a month of therapy, there was a 21% risk reduction in the primary composite endpoint of death or hospitalizations that missed statistical significance, compared with placebo among 4488 outpatients enrolled in the global, phase 3 trial.
3. After excluding 329 patients without a confirmatory PCR test, however, the use of colchicine was reported to significantly reduce hospitalizations by 25%, the need for mechanical ventilation by 50%, and deaths by 44%.
4. Colchicine is both inexpensive and generally well tolerated, and the apparent benefits so far reported are substantial
5. It reduced the time of clinical progression of disease and hospital stay but did not affect mortality in the 105-patient Greek Study assessing the Effects of Colchicine in COVID-19 Complications Prevention (GRECCO-19).
6. ColCORONA enrolled 6000 outpatients, at least 40 years of age, who were diagnosed with COVID-19 infection within the previous 24 hours, and had a least one high-risk criterion, including age at least 70 years, body mass index ≥ 30 kg/m2, diabetes mellitus, uncontrolled hypertension, known respiratory disease, heart failure or coronary disease, fever of ≥ 38.4°C within the last 48 hours, dyspnea at presentation, bicytopenia, pancytopenia, or the combination of high neutrophil count and low lymphocyte count.
7. Participants were randomly assigned to receive either placebo or colchicine 0.5 mg twice daily for 3 days and then once daily for another 27 days.
8. The number needed to prevent one COVID-19 complication is about 60 patients.
9. Colchicine was well-tolerated and resulted in fewer severe adverse events than with placebo. Diarrhoea occurred more often with colchicine, but there was no rise in pneumonia cases. Caution should be exercised, however, in treating patients with severe renal disease.

Dr KK Aggarwal

President CMAAO, HCFI and Past National President IMA