Gout drug cuts coronavirus patient hospital stay and need for oxygen, small study suggests

A gout drug may cut short the hospital stay of coronavirus patients, as well as reducing their need for oxygen, research suggests.

The roll-out of long-awaited coronavirus vaccines gives hope for the future. With not everyone able to be immunised, or responding well to the jabs, treatments that fight the infection’s complications remain important.

The drug colchicine helps prevent and treat inflammatory conditions like gout.

With severe coronavirus also being linked to inflammation, scientists from the University of São Paulo gave 36 patients with moderate to serious complications colchicine on top of the standard of care treatment.

Results reveal these patients required four days of oxygen therapy on average, compared to 6.5 days in another 36 people who were just given the standard of care.

The colchicine participants also spent seven days in hospital, versus nine days for the standard of care group.

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Although it is unclear whether colchicine reduces the risk of death, it may be worth adding the cheap drug to a hospital’s treatment arsenal, according to the scientists.

The trial was carried out before the Brazilian variant of the coronavirus is thought to have emerged.

Not everyone is convinced by the results, with one expert saying the study was too small to draw firm conclusions.

Between April and August 2020, 36 patients admitted to hospital with moderate to severe coronavirus complications were given 0.5mg of colchicine three times a day for five days.

The same dose was then given twice a day for five days.

This was on top of the standard of care, which included the antibiotic azithromycin, antimalarial drug hydroxychloroquine and blood thinner heparin.

The steroid methylprednisolone was also administered if the patient “considerably” needed supplemental oxygen.

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Moderate COVID-19 – the disease caused by the coronavirus – was defined as a fever, breathing difficulties and pneumonia.

A severe case included all of the above symptoms, as well as a rapid breathing rate and dangerously low oxygen levels in the blood.

Only five of the study’s participants were not overweight or obese. Carrying an excessive amount of weight has repeatedly been flagged as a risk factor for severe COVID-19.

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The results, published in the journal RMD Open, suggest taking colchicine on top of standard of care led to better patient outcomes than those only on the typical treatment.

By day seven, just under one in 10 (9%) of those given colchicine required maintenance oxygen, compared with more than four in 10 (42%) on the standard of care alone.

Two of the trial participants died, both of whom were in the standard of care only group.

When it came to safety, diarrhoea was more common among those on colchicine, however, the drug was found to be safe and well tolerated overall.

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Colchicine is “very unlikely” to have any direct antiviral properties.

It may lessen the body’s inflammatory response and ward off damage to the cells that line blood vessel walls, suggested the scientists.

“Whatever the mechanism of action, colchicine seems to be beneficial for the treatment of hospitalised patients with COVID-19,” they wrote.

The scientists stressed it is unclear if colchicine may help a hospitalised patient avoid the need for intensive care or reduce their risk of death.

Nevertheless, a shorter hospital stay and reduced oxygen requirements boost patient outcomes, while reducing healthcare costs and freeing up beds.

Speaking of the study, Professor Martin Landray from the University of Oxford said: “There is a lot of interest in the possibility colchicine, an anti-inflammatory treatment commonly used for gout, might improve outcomes for patients with COVID-19.

“This is a very small randomised trial that is consequently unable to answer this question.

“Much larger randomised trials are ongoing and should provide the answers we need.

“For example, the RECOVERY [of which Professor Landray is an investigator] trial has already randomised over 8,000 patients hospitalised to COVID-19 to colchicine versus usual care.”

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