Particularly effective in the treatment of coronavirus seems to be the active substance colchicine, as shown by the results of the Greek clinical research GRECCO-19 which were presented earlier today. The numerous scientific team (consisting of Greek and foreign renowned scientists) under Professor Spyridon Deftereos investigated the potential of colchicine (an old, tested and remarkably cheap drug) to prevent serious damage to the heart and lungs from Covid-19 and the results are encouraging. Professor Deftereos spoke to “Ethnikos Kiryx” about the results of the research. The interview is as follows:
“Ethnikos Kiryx”: What is your central finding?
Dr. Spyridon Deftereos: We studied a total of 105 patients who were hospitalized due to Covid-19. Colchicine patients were less likely to have a worsening of the two clinical categories on the World Health Organization scale than the non-receiving group (1.8% versus 14%). In practice, this means that intubation (ie, severe respiratory failure) was less likely in patients receiving colchicine.
“EK”: What other findings did you have?
Dr. S. Deufereos: We observed lower levels in thrombotic biomarkers in the colchicine group. This suggests more general anticoagulant effects of colchicine. It is noted that the data so far from other studies have highlighted such biomarkers as negative outcome factors for patients with Covid-19.
“EK”: Were there any side effects from the drug and how serious were they?
Dr. S. Deftereos: The main side effects reported were from the gastrointestinal tract (mainly diarrhea – reversed by dose reduction or discontinuation of the drug), as is well known and expected for colchicine. Nothing serious or worrying.
“EK”: What kind of medicine is colchicine?
Dr. S. Deftereos: Colchicine is an old, tested, anti-inflammatory drug which is administered in diseases such as gout, familial Mediterranean fever, pericarditis, etc.
“EK”: Is it useful in heart disease?
Dr. S. Deftereos: In recent years, its action in the cardiovascular system with positive results has been the subject of study. Its classic indication is pericarditis, however it can be given in other situations, such as after an acute myocardial infarction (currently in the context of research protocols).
“EK”: Have you done any other studies with colchicine?
Dr. S. Deftereos: In the last decade, our scientific team has conducted a series of studies on the effect of administration of colchicine on acute myocardial infarction, to prevent re-stenosis of the stents, on heart failure and after atrial fibrillation cataract surgery.
“EK”: How did you plan to use it on Covid-19?
Dr. S. Deftereos: As the first data on Covid-19 disease emerged, the negative role of the body’s excessive inflammatory response to the invader (the virus now called SARS-CoV-2) was quickly understood, and even at the multisystem level – that is, affecting many organs, including the myocardium. Our many years of experience with colchicine, its safety, but also its therapeutic anti-inflammatory properties led us to think of using it to shield the body from the side (negative) inflammatory effects created by Covid-19 disease.
“EK”: How many centers took part in the study?
Dr. S. Deftereos: The initial conception of the GRECCO-19 study was Greek, but the full development of the protocol, the analysis and publication of the results was done with the collaboration of scientists from Greece, Italy (Humanitas Clinical and Research Hospital), Spain ( Hospital Universitario y Politécnico La Fe, Valencia) and the USA (Yale University, Icahn School of Medicine at Mount Sinai) – including Greek Diaspora Scientists. The original purpose was to enroll patients in all these countries, but due to the strict regulatory framework for clinical trials and the short time horizon, this was eventually only possible in Greece. 16 centers in the country were activated in hospitals in Athens, Thessaloniki, Kastoria, Ptolemaida, Kozani, Alexandroupolis, Ioannina and Patras.
“EK”: Have you ever worked with this large network of researchers? Is it common for centers outside of big cities to participate in scientific studies?
Dr. S. Deftereos: The research network of the GRECCO-19 study did not existed before. The participation of centers in the wider territory is not common, as clinical studies are usually conducted in university centers. In our case, in addition to the University Clinics, the contribution of the hospitals of the National Health System, and especially of the province, was significant. I would also like to thank the companies ELPEN, Acarpia, Karian and Hospital Line, which practically supported our research efforts by covering the cost of conducting the study.
“EK”: What do you have to say to the patients who accepted and participated in the study?
Dr. S. Deftereos: As doctors we knew that colchicine has a very good safety profile. Therefore, if nothing else, the risks of participating in this clinical study were small. However, this virus was (and remains) young and there was a generalized insecurity. So their decision to agree to join a clinical study is not that simple. So I would say a big thank you to the patients and their families. Their participation gave a new dimension to the treatment of the virus. After all, in general, everything we “know” in therapy comes mainly from previous studies in which patients from different parts of the world participated and to the patients who participated in them we owe gratitude to both the doctors and the current patients!
“EK”: How can this simple, old and well-known drug be practically used on Covid-19? Will it be useful for us if the 2nd wave comes?
Dr. S. Deftereos: We examined the administration of colchicine to patients with Covid-19 disease which required hospitalization. That is, disease of at least moderate severity. The findings of our study, as well as many others that are currently underway, should be taken into account to make final decisions. Evidence-based medicine is a laborious and lengthy marathon-like process. The inclusion of colchicine in treatment protocols will be judged by the local authorities. However, I would like to remind you that in the first wave, drugs for which there were no data from randomized studies were included in the treatment protocols.
“EK”: Are other studies being conducted on colchicine in Covid-19 and how do they differ?
Dr. S. Deftereos: More than 14 studies on the administration of colchicine to patients with Covid-19 worldwide have been reported so far. Many have similar size dynamics, but others are expected with a much larger number of patients and similar endpoints and populations to ours. Some refer to patients with mild illness and others to prevention. We look forward to these results.
“EK”: We heard a few days ago that a study by the University of Oxford suggests administration of cortisone (dexamethasone to be exact)? Does it act similar? Maybe combined with colchicine, theoretically speaking?
Dr. S. Deftereos: The main course of action is common: the treatment of inflammation. So the results are generally mutually supportive. Dexamethasone was tested in a population that was more severely ill than the population studied in GRECCO-19.
COOPERATIVE CURRICULUM VITAE Spyridon Deftereos was born in Kefalonia, graduated from the Medical School of the University of Athens, specialized in Cardiology and served until the rank of Director at the General Hospital of Athens “G. Gennimatas “. He also trained at Columbus Hospital (Milan, Italy) and Yale University in the United States, where he also served as Adj. Asst. Professor. Today he is a full Professor of Cardiology at the 2nd University Cardiology Clinic (Attikon Hospital) of the National and Kapodistrian University of Athens.