Community Medicine, GMERS Medical College Gotri, Vadodara, Gujarat, India
Pharmacology, AIIMS, Gorakhpur, Uttar Pradesh, India.
RMD Open. 2021 Oct;7(3). doi: 10.1136/rmdopen-2021-001746.
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.
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 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.
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=15%), ventilatory support (risk ratio, RR 0.67 (95% CI 0.38 to 1.21), I=47%), ICU admission (RR 0.49 (95% CI 0.19 to 1.25), I=34%), length of hospital stay (mean difference: -1.17 (95% CI -3.02 to 0.67), I=77%) and serious adverse events (RD -0.01 (95% CI -0.02 to 0.00), I=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=81%) and diarrhoea (RR 1.93 (95% CI 1.62 to 2.29), I=0%) than supportive care treated patients. The GRADE quality of evidence was moderate for most outcomes.
The moderate quality evidence suggests no benefit of addition of colchicine to the standard care regimen in patients with COVID-19.
秋水仙碱是一种抗炎药物，目前被用于治疗 COVID-19。在这项荟萃分析中，我们评估了秋水仙碱在 COVID-19 患者中的疗效和安全性。
我们检索了数据库中的随机对照研究，评估了秋水仙碱与 COVID-19 患者的支持性护理相比的疗效和/或安全性。疗效结局包括死亡率、通气支持、重症监护病房（ICU）入院和住院时间。安全性结局包括不良事件、严重不良事件和腹泻。通过 Mantel-Hanzle 方法使用随机效应模型估计汇总分析结果。使用 I 检验评估异质性。采用推荐、评估、开发和评价（GRADE）方法评估每个结局的证据质量。
在评估的 69 篇全文中，有 6 项研究（16148 例 COVID-19 患者）纳入荟萃分析。接受秋水仙碱治疗的患者死亡率无显著降低（风险差异-0.00（95%CI-0.01 至 0.01），I=15%）、通气支持（风险比 0.67（95%CI 0.38 至 1.21），I=47%）、ICU 入院（RR 0.49（95%CI 0.19 至 1.25），I=34%）、住院时间（平均差-1.17（95%CI-3.02 至 0.67），I=77%）和严重不良事件（RD-0.01（95%CI-0.02 至 0.00），I=28%）的发生率均低于仅接受支持性护理的患者。接受秋水仙碱治疗的患者不良事件（RR 1.58（95%CI 1.07 至 2.33），I=81%）和腹泻（RR 1.93（95%CI 1.62 至 2.29），I=0%）的发生率高于接受支持性护理治疗的患者。大多数结局的 GRADE 证据质量为中等。
中等质量的证据表明，在 COVID-19 患者中，秋水仙碱联合标准治疗方案并无获益。
