Colchicine in COVID-19: an Old Drug, New Use
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COVID-19 (ATY LAU AND A KONG, SECTION EDITORS)
Colchicine in COVID-19: an Old Drug, New Use Naomi Schlesinger 1 & Bonnie L. Firestein 2 & Luigi Brunetti 3 Published online: 18 July 2020 # Springer Nature Switzerland AG 2020
Abstract Purpose of Review Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection, is a pandemic causing havoc globally. Currently, there are no Food and Drug Administration (FDA)-approved drugs to treat COVID-19. In the absence of effective treatment, off-label drug use, in lieu of evidence from published randomized, double-blind, placebo-controlled clinical trials, is common in COVID-19. Although it is vital to treat affected patients with antiviral drugs, there is a knowledge gap regarding the use of anti-inflammatory drugs in these patients. Recent Findings Colchicine trials to combat inflammation in COVID-19 patients have not received much attention. We await the results of ongoing colchicine randomized controlled trials in COVID-19, evaluating colchicine’s efficacy in treating COVID-19. Summary This review gives a spotlight on colchicine’s anti-inflammatory and antiviral properties and why colchicine may help fight COVID-19. This review summarizes colchicine’s mechanism of action via the tubulin-colchicine complex. Furthermore, it discussed how colchicine interferes with several inflammatory pathways, including inhibition of neutrophil chemotaxis, adhesion, and mobilization; disruption of superoxide production, inflammasome inhibition, and tumor necrosis factor reduction; and its possible antiviral properties. In addition, colchicine dosing and pharmacokinetics, as well as drug interactions and how they relate to ongoing, colchicine in COVID-19 clinical trials, are examined. Keywords Colchicine . Colchicine-tubulin complex . Anti-inflammatory . COVID-19 . SARS-CoV-2 infection . Antiviral
Introduction Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection, is a pandemic causing havoc globally. Currently, there are no Food and Drug Administration (FDA)-approved drugs to treat COVID-19. Off-label drug use, in lieu of evidence This article is part of the Topical Collection on Covid-19 * Naomi Schlesinger [email protected] 1
Division of Rheumatology, Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ 08903-0019, USA
2
Department of Cell Biology and Neuroscience, Rutgers, The State University of New Jersey, Piscataway, NJ 08854-8082, USA
3
Department of Pharmacy Practice and Administration, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
from published randomized, double-blind, placebocontrolled clinical trials, is common in COVID-19. Although it is vital to treat affected patients with antiviral drugs, there is a knowledge gap regarding the use of antiinflammatory drugs in these patients. One critical question is which anti-inflammatory drugs are most appropriate. At present
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