Efficacy and safety of colchicine in COVID-19: a meta-analysis of randomised controlled trials

Background Colchicine, an anti-inflammatory drug is prescribed nowadays for COVID-19. In this meta-analysis, we evaluated efficacy and safety of colchicine in patients with COVID-19. Methods We searched databases for randomised controlled studies evaluating efficacy and/or safety of colchicine as compared with supportive care in patients with COVID-19. The efficacy outcomes were mortality, ventilatory support, intensive care unit (ICU) admission and length of hospital stay. The safety outcomes were adverse events, serious adverse events and diarrhoea. A meta-analytical summary was estimated using random effects model through Mantle-Hanzle method. An I-2 test was used to assess heterogeneity. The Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach was used to assess quality of evidence for each outcome. Results Out of 69 full texts assessed, 6 studies (16148 patients with COVID-19) were included in meta-analysis. Patients receiving colchicine did not show significant reduction in mortality (risk difference, RD -0.00 (95% CI -0.01 to 0.01), I-2=15%), ventilatory support (risk ratio, RR 0.67 (95% CI 0.38 to 1.21), I-2=47%), ICU admission (RR 0.49 (95% CI 0.19 to 1.25), I-2=34%), length of hospital stay (mean difference: -1.17 (95% CI -3.02 to 0.67), I-2=77%) and serious adverse events (RD -0.01 (95% CI -0.02 to 0.00), I-2=28%) than those who received supportive care only. Patients receiving colchicine had higher rates of adverse events (RR 1.58 (95% CI 1.07 to 2.33), I-2=81%) and diarrhoea (RR 1.93 (95% CI 1.62 to 2.29), I-2=0%) than supportive care treated patients. The GRADE quality of evidence was moderate for most outcomes. Conclusion The moderate quality evidence suggests no benefit of addition of colchicine to the standard care regimen in patients with COVID-19.