Colchicine in COVID-19: an Old Drug, New Use

Schlesinger, Naomi; Firestein, Bonnie L.; Brunetti, Luigi

doi:10.1007/s40495-020-00225-6

Cited by 110 publications

(119 citation statements)

References 43 publications

(54 reference statements)

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“…In this context, colchicine is a low-cost, widely available drug to treat diseases with an auto-inflammatory phenotype such as familial Mediterranean fever, Behçet’s disease and gouty arthritis. Anti-inflammatory properties of colchicine, mainly neutrophil chemotaxis inhibition and blockage of NLRP3 inflammasome are important targets in COVID-19 pathogenesis and are being evaluated in clinical trials [ 25 ].…”

Section: Virus and Host Interactionmentioning

confidence: 99%

Severe COVID-19: what have we learned with the immunopathogenesis?

et al. 2020

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The COVID-19 outbreak caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a global major concern. In this review, we addressed a theoretical model on immunopathogenesis associated with severe COVID-19, based on the current literature of SARS-CoV-2 and other epidemic pathogenic coronaviruses, such as SARS and MERS. Several studies have suggested that immune dysregulation and hyperinflammatory response induced by SARS-CoV-2 are more involved in disease severity than the virus itself. Immune dysregulation due to COVID-19 is characterized by delayed and impaired interferon response, lymphocyte exhaustion and cytokine storm that ultimately lead to diffuse lung tissue damage and posterior thrombotic phenomena. Considering there is a lack of clinical evidence provided by randomized clinical trials, the knowledge about SARS-CoV-2 disease pathogenesis and immune response is a cornerstone to develop rationale-based clinical therapeutic strategies. In this narrative review, the authors aimed to describe the immunopathogenesis of severe forms of COVID-19.

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Section: Virus and Host Interactionmentioning

confidence: 99%

Severe COVID-19: what have we learned with the immunopathogenesis?

et al. 2020

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“…Besides, this drug modulates several pro-and anti-inflammatory pathways. It has been reported that colchicine significantly decreases virus replication in flaviviruses, such as dengue and Zika viruses, hepatitis virus and HIV viral load [47]. A study on 4745 patients was reported that colchicine significantly decreased cardiovascular risk and pneumonia [79].…”

Section: Colchicinementioning

confidence: 99%

“…Treatment with 1 mg of colchicine on day 8 and then 0.5 mg/day was reported to be beneficial found in a case report of a COVID-19-infected patient [91]. The absorption of colchicine occurs in the jejunum and ileum and accumulates in tissues that is metabolized in the liver and the intestine by cytochrome P (CYP) 450 3A4 and P-glycoprotein (P-gp) [47]. Overdose of colchicine has been associated with several adverse effects, including diarrhea, GIT adverse event, headache, fever, and myopathy [57].…”

Section: Colchicinementioning

confidence: 99%

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A Review on Current Repurposing Drugs for the Treatment of COVID-19: Reality and Challenges

Hossen

Barek

Jahan

et al. 2020

SN Compr. Clin. Med.

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The coronavirus disease 2019 (COVID-19) caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a global pandemic with a high growth rate of confirmed cases. Therefore, therapeutic options are desperately urgent to fight with this damning virus. As it may take years to develop a specific therapy of COVID-19, it is urgent to emphasize the repurposing of drugs used for other conditions. This study reviewed the most common drugs for COVID-19 based on available online literature representing the latest in vitro clinical trial database, rational of use, adverse effects, potential toxicities, and US National Institute of Health (NIH) recommendation to use for COVID-19. Based on the preliminary data from clinical trials and considering the NIH and FDA recommendation, remdesivir and convalescent blood products are the most promising potential for COVID-19 treatment. The use of chloroquine, hydroxychloroquine, favipiravir, ivermectin, and colchicine might also be effective. However, furthermore, in vivo investigations are needed in detail individually and in combination for possible benefits in humans. Besides, tocilizumab might be deemed as adjunctive therapy for patients with cytokine release syndrome. However, lopinavir-ritonavir, anakinra, and sarilumab had not proven their clinical efficacy. Eventually, sarilumab has been withdrawn from sponsored clinical trials based on the preliminary data. Baricitinib and ruxolitinib have the additive immunosuppressive effect. Consequently, all of these drugs are being evaluated with further studies. In addition, drug-drug interaction and safety concerns must be taken into account before the administration of the recommended drugs.

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“…Colchicine can interfere with multiple inflammatory pathways, thus exerting anti-inflammatory and antiviral effects in the treatment of COVID-19. 39,40 Additionally, melatonin has significant antioxidant and anti-inflammatory properties. 41 A recently approved study (EudraCT: 2020-001808-42) aims to evaluate its dosage and efficacy in the treatment of COVID-19.…”

mentioning

confidence: 99%