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We thank Drs Perricone et al for their thoughtful response1 to our manuscript, and agree that timing, dose and duration of colchicine will be important open questions should the agent be found to be helpful in COVID-19. Regarding the question of when in the COVID-19 course colchicine might be most efficacious, we postulated that earlier (ie, as an outpatient) might be better. In making this suggestion, we followed Perricone et al’s recommendation to apply clinical rheumatologic experience. In gout, colchicine seems to be most effective early in acute disease, compelling both the the American College of Rheumatology and the European League Against Rheumatism to recommend treating gout flares with colchicine only in the earliest stages of the attack (ie, within 1–2 days of onset)2 3; these recommendations suggest that administration of colchicine in the earliest stages of COVID-19 might be more effective than …
BS and AZR are joint first authors.
J-CT and MHP are joint senior authors.
Handling editor Josef S Smolen
Contributors All authors contributed to conception or design of this correspondence response; drafting the work or revising it critically for important intellectual content; final approval of the version to be published; and 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 Commissioned; internally peer reviewed.