Colchicine: the Ministry of Health “happy”, but cautious

The results of the study conducted by the Montreal Heart Institute which concludes that colchicine is effective in preventing complications related to COVID-19 are welcomed by the Ministry of Health in Quebec. But he wants an opinion from the National Institute of Excellence in Health and Social Services (INESSS) before issuing an official recommendation.

“We are happy that such a study has been completed, but we wish to take the time to analyze the results of it and to request an opinion from INESSS before issuing any comments on it,” said Sunday. at Duty Marjorie Larouche, ministry spokesperson.

“At the appropriate time, the ministry will communicate its recommendations regarding the use of colchicine in Quebec in patients with COVID-19,” she adds.

Friday evening, Prime Minister Legault had succinctly described as “big news” the conclusions of the COLCORONA study, led by Dr. Jean-Claude Tardif of the Research Center of the Montreal Heart Institute (ICM).

Launched at the start of the pandemic in March, the study involved 4,159 patients whose diagnosis of COVID-19 had been proven by a nasopharyngeal test. Analysis of the results shows that colchicine “led to reductions in hospitalizations by 25%, the need for mechanical ventilation by 50%, and deaths by 44%”.

Likewise, “the results of the study showed that colchicine reduced by 21% the risk of death or hospitalization in patients with COVID-19, compared to the placebo”, noted the press release issued on Friday by the ICM. “Our study has shown the effectiveness of treatment using colchicine to prevent the phenomenon of ‘major inflammatory storm’ and reduce complications related to COVID-19,” said Dr Tardif.

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“Treating patients at risk of complications with colchicine as soon as the diagnosis of COVID-19 is confirmed by PCR reduces their risk of developing a serious form of the disease and consequently reduces the number of hospitalizations, also says the text. Prescribing colchicine to patients could help alleviate the problems of hospital congestion and reduce costs to government health systems here and elsewhere. “

Inexpensive

The keen interest in this study is due in particular to the fact that colchicine is an anti-inflammatory drug already available in the form of an oral tablet, and that it is inexpensive. “Colchicine is as old as the world, we have been treating gout with that for hundreds of years,” summarized Dr. Tardif to The Canadian Press on Friday. It is available in pharmacies, so any doctor tomorrow who reads this, can decide to prescribe it if he wants ”.

Except that the press release on Friday also specified the result obtained for all the patients in the study “approached statistical significance” – which implies that we are not quite there either. Geriatrician Quoc Nguyen, of the Center hospitalier de l’Université de Montréal, also noted this nuance on Twitter on Saturday. “As soon as the COLCORONA study is published, expect rigorous and contested debates on the interpretation of the hypothesis tests, the importance (or not) of the statistically significant,” he predicted.

The study was taking place at home, “randomized, double-blind and placebo-controlled,” the ICM said on Friday. That is to say, “neither the patient, nor the team managing the study, knew whether the patient was taking the placebo or the drug,” explained Dr. Tardif. It has been deployed in Canada, the United States, Europe, South America and South Africa.

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