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I can scarcely believe this, but if so, this is an amazing result. @matthewherper @GermHunterMD @walidgellad @mikejohansenmd https://thecanadian.news/2021/01/23/major-breakthrough-large-study-shows-effectiveness-of-colchicine-to-treat-covid-19/
With all the usual caveats of science by press release, couple of initial observations:
1. Keep in mind that this trial (COLCORONA) was done in outpatients, but those at very high risk of progression (e.g., 70 years or more of age)
1. Keep in mind that this trial (COLCORONA) was done in outpatients, but those at very high risk of progression (e.g., 70 years or more of age)
2. It's striking (and odd) that the endpoints traditionally used for studies of hospitalized patients (progression to mechanical ventilation, mortality) saw larger effect sizes (44%, 50%) than the endpoints used for outpatients (hospitalization, 25%)
3. The dosing regimen in this trial was 0.5 mg BID for 3 days, followed by QD for 27 days.
4. Between 2. and 3. I believe that my initial hypothesis is that the drug was acting mostly as an anti-inflammatory to help patients once they had progressed *into* the hospital.
4. Between 2. and 3. I believe that my initial hypothesis is that the drug was acting mostly as an anti-inflammatory to help patients once they had progressed *into* the hospital.
5. I am curious to see the confidence intervals and overall base rates for mortality, hospitalization, and progression to ventilation in this trial. I would not have believed that an outpatient trial, even of 4000+ patients, could show a significant effect on mortality.
6. If I'm right, it turns out that broad-spectrum immunosuppression is the *best* strategy we have to treat COVID.
