University of Queensland School of Clinical Medicine, Queensland, Australia.
University of Queensland School of Clinical Medicine, Queensland, Australia.
Semin Arthritis Rheum. 2021 Feb;51(1):101-112. doi: 10.1016/j.semarthrit.2020.11.007. Epub 2020 Dec 17.
Colchicine has been used historically as an anti-inflammatory agent for a wide range of diseases. Little is known regarding the relationship between colchicine use and infectious disease outcomes. The objective of this study was to systematically examine infectious adverse events associated with colchicine usage and the clinical use of colchicine for infectious diseases.
A systematic review was conducted in accordance with PRISMA methodology. PubMed, EMBASE, Scopus and Cochrane Library databases were searched (up to 12 October, 2020) for interventional and observational studies that included colchicine usage associated with infectious adverse events or infectious disease outcomes.
A total of 9,237 studies were initially identified and after exclusions, 36 articles comprising 21 interventional studies and 15 observational studies were included in this systematic review. There were 19 studies that reported infectious adverse events and 17 studies that examined the efficacy of colchicine in treating infectious disease. Only two out of six studies reported a significant benefit using colchicine in the management of viral liver disease. There was some evidence colchicine is beneficial in managing COVID-19 by reducing time to deterioration, length of stay in hospital and mortality. Colchicine had some benefit in managing malaria, condyloma accuminata and verruca vulgaris, viral myocarditis and erythema nodosum leprosum based on case-series or small, pilot clinical studies. Two of the clinical trials and five of the observational studies reported significant associations between infections adverse events and colchicine usage. Risk of pneumonia was found in three studies and post-operative infections were reported in two studies. Risks of urinary tract infections, H. pylori and C.difficile were only reported by one study each.
There is a current lack of clinical evidence that colchicine has a role in treating or managing infectious diseases. Preliminary studies have demonstrated a possible role in the management of COVID-19 but results from more clinical trials are needed. There is inconclusive evidence that suggests colchicine is associated with increased risk of infections, particularly pneumonia.
秋水仙碱历史上被用作治疗多种疾病的抗炎药物。然而，关于秋水仙碱的使用与感染性疾病结局之间的关系，人们知之甚少。本研究的目的是系统地研究与秋水仙碱使用相关的感染性不良事件以及临床用于治疗感染性疾病的秋水仙碱。
本研究按照 PRISMA 方法进行了系统回顾。检索了 PubMed、EMBASE、Scopus 和 Cochrane Library 数据库（截至 2020 年 10 月 12 日），以查找包括与感染性不良事件或感染性疾病结局相关的秋水仙碱使用的干预性和观察性研究。
最初共确定了 9237 项研究，排除后，本系统综述共纳入 36 篇文章，包括 21 项干预性研究和 15 项观察性研究。有 19 项研究报告了感染性不良事件，17 项研究评估了秋水仙碱治疗感染性疾病的疗效。在管理病毒性肝病方面，仅有两项研究报告了秋水仙碱的使用具有显著益处。有一些证据表明，秋水仙碱通过降低病情恶化的时间、住院时间和死亡率，对管理 COVID-19 有益。基于病例系列或小型临床试验，秋水仙碱对管理疟疾、尖锐湿疣、寻常疣、病毒性心肌炎和结节性红斑具有一定益处。两项临床试验和五项观察性研究报告了感染性不良事件与秋水仙碱使用之间存在显著关联。有三项研究报告了肺炎风险，两项研究报告了术后感染风险。仅有一项研究报告了尿路感染、幽门螺杆菌和艰难梭菌感染的风险。
目前缺乏临床证据表明秋水仙碱在治疗或管理感染性疾病方面具有作用。初步研究表明，它在 COVID-19 管理方面可能具有作用，但需要更多临床试验的结果。有一些不确定的证据表明，秋水仙碱与感染风险增加相关，特别是肺炎风险增加。
