Table 1: Trials on going with colchicine in SARS-Cov-2 patients.(Clinicaltrials.gov)
Since 1972 colchicine (at the dose of 0.5-2 mg/day) is the drug used in the prophylaxis of FMF attacks. The idea and hypothesis of extending the use of colchicine in SARS-Cov2 infection is closely related to its use in FMF, i.e. a hereditary autoinflammatory disease characterized by recurrent febrile episodes (attacks) and acute inflammation. For these considerations, the mechanism of action is similar; in fact, the use of colchicine up to a maximum dose of 3 mg/day is effective in preventing the onset of inflammatory attacks in 60-65% of FMF cases. Considering the pharmacodynamic properties of colchicine and based on knowledge of its tolerability profile (derived from the use of drugs for many years), the use of this drug could be considered in monotherapy or in combination in all three phases of coronavirus infection, in the first phase as prophylaxis, in the second and third phase as a CS blocker as shown in Table 2 and described below.