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Correspondence
Colchicine treatment in community healthcare setting to prevent severe COVID-19
  1. Emanuel Della-Torre1,2,
  2. Giuseppe A Ramirez1,2,
  3. Lorenzo Dagna1,2,
  4. Moreno Tresoldi3
  1. 1 Università Vita-Salute San Raffaele, San Raffaele Scientific Institute, Milan, Italy
  2. 2 Unit of Immunology, Rheumatology, Allergy, and Rare Diseases (UnIRAR), San Raffaele Scientific Institute, Milan, Italy
  3. 3 Unit of General Medicine and Advanced Care, San Raffaele Scientific Institute, Milan, Italy
  1. Correspondence to Dr Emanuel Della-Torre, Università Vita-Salute San Raffaele, San Raffaele Scientific Institute, Milan, Italy; dellatorre.emanuel{at}hsr.it

https://doi.org/10.1136/annrheumdis-2020-218759

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    We read with interest the article from Scarsi and colleagues about the efficacy of colchicine in hospitalised patients with severe COVID-19.1 Colchicine is an ‘old drug’ originally approved for the treatment of gout and subsequently repositioned in numerous disease settings characterised by systemic inflammation and uncontrolled activation of the innate immune response.2 3 During the recent outbreak of SARS-CoV-2 infection, uncontrolled release of major proinflammatory cytokines such as interleukin (IL)-1 and IL-6 soon emerged as a major pathological feature of COVID-19 as well as a predictor of patients’ morbidity and mortality.4 5

    Based on this evidence, hospitalised patients with severe COVID-19 are currently being treated with anti-cytokine biological drugs including the IL-1 receptor antagonist anakinra, the anti-granulocyte-macrophage colony-stimulating factor mavrilimumab and the IL-6 receptor blockers tocilizumab and sarilumab.6–9 Yet, although these targeted approaches have provided encouraging results in preliminary retrospective cohorts, they do not seem to induce a prompt recovery as optimistically expected, likely because administered at …

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    Footnotes

    • Contributors All authors contributed to the design of the work, acquisition, analysis and interpretation of data. All authors revised the work critically for important intellectual content and approved the final version of the manuscript. All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; internally peer reviewed.

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