Covid-19 living Data

Pharmacologic treatments for covid-19 patients

Colchicine vs Standard care/Placebo

This comparison will not be updated. Last search date 28 Feb, 2022.

Outpatients

Forest plots
(last update: 2022-04-29)

Summary of findings
(last update: 2022-05-24)

Patient or population: COVID-19 patients
Setting: Worldwide
Intervention: Colchicine
Comparison: Standard care/Placebo

Outcome	Relative effect (95% CI)	Absolute effect (95% CI)¹		Certainty of the Evidence (GRADE)
Clinical improvement D28	Outcome not yet measured or reported
Clinical improvement D60	Outcome not yet measured or reported
Hospitalisation or death	RR: 0.91 (0.51 - 1.62)	5 fewer per 1000 (from 28 fewer to 35 more)		Low certainty Reasons to downgrade Risk of bias: Not serious Despite some concerns with deviation from intended intervention and missing data, not downgraded for risk of bias because the study with these concerns contributed only a small proportion of weight to the effect estimate Inconsistency: Not serious Indirectness: Not serious Imprecision: Very serious due to wide confidence interval consistent with the possibility for benefit and the possibility for harm and low number of events
2 trials Tardif JC, 2021; Doward J, 2021 4764 participants		Colchicine 51 per 1,000 (29 - 91)	Standard care/Placebo 56 per 1,000
WHO progression score (level 7 or above) D28	RR: 0.26 (0.01 - 6.25)	6 fewer per 1000 (from 8 fewer to 44 more)		Very low certainty Reasons to downgrade Risk of bias: Not serious Inconsistency: Not serious Indirectness: Serious despite a multicentre design this is a single study from a single country, therefore results in this population might not be generalizable to other settings. Imprecision: Very serious due to very wide confidence interval consistent with the possibility for benefit and the possibility for harm
1 trials Doward J, 2021 276 participants		Colchicine 2 per 1,000 (0 - 52)	Standard care/Placebo 8 per 1,000
WHO progression score (level 7 or above) D60	Outcome not yet measured or reported
All-cause mortality D28	RR: 0.52 (0.18 - 1.45)	2 fewer per 1000 (from 3 fewer to 2 more)		Low certainty Reasons to downgrade Risk of bias: Not serious Despite some concerns with deviation from intended intervention and missing data, not downgraded for risk of bias because the studies with these concerns contributed only a small proportion of weight to the effect estimate Inconsistency: Not serious Indirectness: Not serious Imprecision: Very serious due to very wide confidence interval consistent with the possibility for benefit and the possibility for harm
2 trials Tardif JC, 2021; Doward J, 2021 4764 participants		Colchicine 2 per 1,000 (1 - 6)	Standard care/Placebo 4 per 1,000
All-cause mortality D60	Outcome not yet measured or reported
Viral negative conversion D7	Outcome not yet measured or reported
Adverse events	RR: 1.56 (1.38 - 1.76)	86 more per 1000 (from 58 more to 116 more)		High certainty Reasons to downgrade Risk of bias: Not serious Inconsistency: Not serious Indirectness: Not serious We presume that the adverse event rates and the corresponding relative risks, are similar across diverse settings, therefore not downgraded for indirectness Imprecision: Not serious
1 trials Tardif JC, 2021 4488 participants		Colchicine 238 per 1,000 (211 - 269)	Standard care/Placebo 153 per 1,000
Serious adverse events	RR: 0.78 (0.61 - 1.00)	14 fewer per 1000 (from 24 fewer to 0 fewer)		Moderate certainty Reasons to downgrade Risk of bias: Not serious Inconsistency: Not serious Indirectness: Not serious We presume that the adverse event rates and the corresponding relative risks, are similar across diverse settings, therefore not downgraded for indirectness Imprecision: Serious due to low number of events
1 trials Tardif JC, 2021 4488 participants		Colchicine 48 per 1,000 (38 - 62)	Standard care/Placebo 62 per 1,000

¹The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI)

CI: Confidence interval; RR: Risk ratio

GRADE Working Group grades of evidence
High certainty: We are very confident that the true effect lies close to that of the estimate of the effect
Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different
Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect
Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect

Hospitalized patients

Forest plots
(last update: 2022-06-10)

Summary of findings
(last update: 2022-06-10)

Patient or population: COVID-19 patients
Setting: Worldwide
Intervention: Colchicine
Comparison: Standard care/Placebo

Outcome	Relative effect (95% CI)	Absolute effect (95% CI)¹		Certainty of the Evidence (GRADE)
Clinical improvement D28	RR: 1.03 (0.98 - 1.08)	21 more per 1000 (from 14 fewer to 57 more)		Moderate certainty Reasons to downgrade Risk of bias: Serious Risk of bias downgraded by 1 level: risk of bias downgraded by 1 level: some concerns regarding adequate randomization, deviation from intended intervention, outcome measurement and selection of reported results Inconsistency: Not serious Indirectness: Not serious Imprecision: Not serious
5 trials Lopes MIF, 2021; Horby P, 2021; Pascual-Figal DA, 2021; Bonifacio L, 2021; Abasalon-Aguilar A, 2021 11664 participants		Colchicine 730 per 1,000 (695 - 766)	Standard care/Placebo 709 per 1,000
Clinical improvement D60	Outcome not yet measured or reported
WHO progression score (level 7 or above) D28	RR: 0.85 (0.72 - 1.02)	39 fewer per 1000 (from 72 fewer to 5 more)		Low certainty Reasons to downgrade Risk of bias: Not serious Inconsistency: Not serious Indirectness: Not serious Imprecision: Very serious due to very wide confidence interval consistent with the possibility for benefit and the possibility for no effect and low number of participants
4 trials Deftereos S, 2020; Pascual-Figal DA, 2021; Diaz R, 2021; Abasalon-Aguilar A, 2021 1608 participants		Colchicine 219 per 1,000 (185 - 263)	Standard care/Placebo 257 per 1,000
WHO progression score (level 7 or above) D60	Outcome not yet measured or reported
All-cause mortality D28	RR: 0.99 (0.93 - 1.06)	2 fewer per 1000 (from 14 fewer to 12 more)		Moderate certainty Reasons to downgrade Risk of bias: Not serious Despite some concerns regarding adequate randomisation, deviation from intended intervention and selection of reported results, not downgraded for risk of bias because the studies with these concerns contributed only a small proportion of weight to the effect estimate Inconsistency: Not serious Indirectness: Not serious Imprecision: Serious due to wide confidence interval consistent with the possibility for benefit and the possibility for harm
8 trials Deftereos S, 2020; Lopes MIF, 2021; Salehzadeh F, 2020; Horby P. 2021; Pascual-Figal DA, 2021; Absalon- Aguilar A, 2021; Diaz R, 2021; Bonifacio L, 2022 13153 participants		Colchicine 201 per 1,000 (189 - 215)	Standard care/Placebo 203 per 1,000
All-cause mortality D60	RR: 0.27 (0.01 - 5.92)	91 fewer per 1000 (from 124 fewer to 615 more)		Very low certainty Reasons to downgrade Risk of bias: Serious Risk of bias downgraded by 1 level: some concerns regarding adequate randomization, deviation from intended intervention, and selection of the reported results Inconsistency: Not serious Indirectness: Serious despite a multicentre design this is a single study from a single country, therefore results in this population might not be generalizable to other settings. Imprecision: Very serious due to very wide confidence interval consistent with the possibility for benefit and the possibility for harm
1 trials Bonifacio L, 2021 18 participants		Colchicine 34 per 1,000 (1 - 740)	Standard care/Placebo 125 per 1,000
Viral negative conversion D7	Outcome not yet measured or reported
Adverse events	RR: 1.20 (0.91 - 1.57)	65 more per 1000 (from 29 fewer to 185 more)		Low certainty Reasons to downgrade Risk of bias: Serious Risk of bias downgraded by 1 level: some concerns regarding adequate randomization deviation from intended intervention, outcome measurement and selection of reported results Inconsistency: Not serious Indirectness: Not serious Imprecision: Very serious due to wide confidence interval consistent with the possibility for no effect/trivial effect and the possibility for harm
4 trials Lopes MIF, 2021; Pascual-Figal DA, 2021; Absalon-Aguilar, 2021; Diaz R, 2021; Bonifacio L, 2022 1603 participants		Colchicine 389 per 1,000 (295 - 508)	Standard care/Placebo 324 per 1,000
Serious adverse events	RR: 0.20 (0.01 - 3.99)	10 fewer per 1000 (from 12 fewer to 36 more)		Very low certainty Reasons to downgrade Risk of bias: Serious Risk of bias downgraded by 1 level: some concerns regarding deviation from intended intervention, outcome measurement and selection on reported results Inconsistency: Not serious Indirectness: Not serious Imprecision: Very serious due to very wide confidence interval consistent with the possibility for benefit and the possibility for harm
3 trials Deftereos S, 2020; Pascual-Figal DA, 2021; Abasalon-Aguilar A, 2021 329 participants		Colchicine 2 per 1,000 (0 - 48)	Standard care/Placebo 12 per 1,000

¹The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI)

CI: Confidence interval; RR: Risk ratio

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click here for Outpatients
click here for Hospitalized patients

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Permanent URL for this comparison: https://covid-nma.com/living_data/index.php?comparison=30

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Trial	Funding	Comparisons		Design	Participants	Sample size	Overall risk of bias Highest assessment	Full description
		Treatment 1	Treatment 2
IRCT20190810044500N5 Pourdowlat G, Phytother Res, 2022 Full text Commentary	Not reported/unclear	Colchicine	Standard care	RCT	Outpatients and inpatients with confirmed COVID-19 (unclear severity) treated or admitted to 5 centres in Iran	N=202	Some concerns Details	Full description
N/A Alsultan M, Interdiscip Perspect Infect Dis, 2021 Full text Commentary	Not reported/unclear	Colchicine Budesonide Colchicine	Standard care Standard care Budesonide	RCT	Patients with suspected or confirmed COVID-19 (moderate-severe) admitted to a single center in Syria.	N=49	N/A	Full description
NCT04328480 ECLA PHRI COLCOVID Diaz R, JAMA Netw Open, 2021 Full text Commentary Commentary	Mixed	Colchicine	Standard care	RCT	Patients with suspected or confirmed COVID-19 (mild-critical) admitted to 42 centers in Argentina.	N=1279	Some concerns Details	Full description
NCT04367168 COLCHIVID Absalon-Aguilar A, J Gen Intern Med, 2021 Full text Commentary	Public/non profit	Colchicine	Placebo	RCT	Patients with confirmed COVID-19 (severe) admitted to 2 centers in Mexico	N=116	Some concerns Details	Full description
NCT04724629 STRUCK Bonifacio L, SSRN, 2022 Full text Full text Commentary	Mixed	Ixekizumab Interleukin-2 Colchicine	Standard care	RCT	Patients with confirmed COVID-19 (moderate-severe-critical) admitted to 5 centers in Brazil.	N=60	Some concerns Details	Full description
ISRCTN86534580 PRINCIPLE Dorward J, medRxiv, 2021 Full text Commentary Commentary	Public/non profit	Colchicine	Standard care	RCT	Outpatients with suspected or confirmed COVID-19 (symptomatic) treated at multiple primary care centers or at home in the UK.	N=276	Some concerns Details	Full description
NCT04350320 ; EUDRACT 2020-001511-2 COL-COVID Pascual-Figal DA, Int J Gen Med, 2021 Full text Commentary	Public/non profit	Colchicine	Standard care	RCT	Patients with confirmed COVID-19 (mild-moderate) admitted to hospital in Spain.	N=103	Some concerns Details	Full description
NCT04381936 ; ISRCTN50189673 RECOVERY (COL) Horby P, Lancet Respir Med, 2021 Full text 00435-5/fulltext; Full text Commentary Commentary	Mixed	Colchicine	Standard care	RCT	Patients with suspected or confirmed COVID-19 (mild-critical) admitted to 177 centers in the UK, 2 centers in Indonesia, and 2 centers in Nepal	N=11340	Some concerns Details	Full description
NCT04322682 COLCORONA Tardif JC, Lancet Respir Med, 2021 Full text Commentary Commentary	Public/non profit	Colchicine	Placebo	RCT	Outpatients with suspected or confirmed COVID-19 (mild) at multiple centers in Brazil, Canada, Greece, South Africa, Spain, USA	N=4488	Some concerns Details	Full description
IRCT20200418047126N1 Salehzadeh F, Research Square, 2020 Full text Commentary	Public/non profit	Colchicine	Placebo	RCT	Patients with confirmed COVID-19 (unclear severity) admitted to a single center in Iran	N=100	Some concerns Details	Full description
RBR-8jyhxh Lopes MIF, RMD Open, 2021 Full text Commentary	Public/non profit	Colchicine	Placebo	RCT	Patients with confirmed COVID-19 (moderate-severe) admitted to a single center in Brazil	N=75	Some concerns Details	Full description
NCT04326790 Deftereos S, JAMA, 2020 Full text Commentary	Private	Colchicine	Standard care	RCT	Patients with COVID-19 (moderate-severe) admitted to 16 centers in Greece.	N=110	Some concerns Details	Full description