A common gout medication, colchicine, is now under investigation as a potential treatment for COVID-19 in hospitalized patients as part of the University of Oxford’s RECOVERY trial. The RECOVERY trial is the world's largest clinical trial of treatments for patients hospitalized with COVID-19.
Colchicine, known for its anti-inflammatory effects, has been used for centuries to treat gout and more recently, other inflammatory conditions. Researchers aim to determine if colchicine can mitigate the severe inflammatory response associated with COVID-19, which can lead to lung damage, the need for mechanical ventilation, and death.
Trial Design and Dosage
Approximately 2,500 patients hospitalized with COVID-19 in the UK will receive colchicine, while another 2,500 patients will form a control group receiving standard care. The colchicine regimen involves an initial dose of 1,000 micrograms, followed by 500 micrograms every 12 hours for ten days. The primary endpoint is to assess whether colchicine reduces the chance of death after 28 days.
Rationale for Colchicine
Professor Peter Horby, an Oxford University Professor and co-chief investigator for the trial, stated, 'Colchicine is an attractive drug to evaluate in the RECOVERY trial as it is very well understood, inexpensive and widely available.' He added, 'Inflammation (caused by an over-active immune system) is a key component of severe COVID-19, and can lead to lung damage, the need for mechanical ventilation, and death.'
Professor Martin Landray, from the Nuffield Department of Population Health at the University of Oxford, who co-leads the RECOVERY trial, says: 'Inflammation plays a major role in COVID-19 and we’ve already shown that treatment with one anti-inflammatory drug, dexamethasone, can reduce deaths in the most severely ill COVID-19 patients. Colchicine is very widely used to treat gout and other inflammatory conditions such as pericarditis. By including colchicine in the RECOVERY trial, we will be able to establish whether it helps tackle the worst consequences of COVID-19.'
RECOVERY Trial Background
The RECOVERY trial has involved over 12,000 coronavirus patients in the UK. Previous findings from the trial demonstrated that dexamethasone, a steroid, can reduce the risk of death by a third for seriously ill patients. The trial has also shown that hydroxychloroquine and the HIV treatment combination of lopinavir-ritonavir are ineffective against COVID-19.
Other treatments being investigated in the RECOVERY trial include aspirin, convalescent plasma, and the Regeneron antibody cocktail (REGN-COV2).
