Edoxaban and/or colchicine for patients with coronavirus disease 2019 managed in the out-of-hospital setting (CONVINCE): a randomized clinical trial

Landi et al., Journal of Cardiovascular Medicine, doi:10.2459/JCM.0000000000001639, CONVINCE, NCT04516941, May 2024
Hospitalization -4% improvement lower risk ← → higher risk Oxygen therapy -5% Analgesic need 40% Viral clearance 11% Colchicine  CONVINCE  LATE TREATMENT RCT Is late treatment with colchicine beneficial for COVID-19? RCT 59 patients in multiple countries No significant difference in outcomes seen c19early.org Landi et al., J. Cardiovascular Medicine, May 2024 0 0.5 1 1.5 2+ RR
Colchicine for COVID-19
5th treatment shown to reduce risk in September 2020, now with p = 0.0000049 from 54 studies.
Lower risk for mortality, ICU, hospitalization, and recovery.
No treatment is 100% effective. Protocols combine treatments.
6,600+ studies for 220+ treatments. c19early.org
Early terminated RCT with 14 colchicine, 13 edoxaban, 16 colchicine+edoxaban, and 16 control patients, showing no significant difference in outcomes with treatment up to 7 days after PCR diagnosis.
risk of hospitalization, 4.0% higher, RR 1.04, p = 0.98, treatment 30, control 29.
risk of oxygen therapy, 5.0% higher, RR 1.05, p = 0.97, treatment 30, control 29.
risk of analgesic need, 40.0% lower, RR 0.60, p = 0.97, treatment 30, control 29.
risk of no viral clearance, 11.0% lower, RR 0.89, p = 0.77, treatment 30, control 29.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Landi et al., 28 May 2024, Randomized Controlled Trial, multiple countries, peer-reviewed, 11 authors, trial NCT04516941 (history) (CONVINCE).
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"reference": [ { "DOI": "10.1016/S0140-6736(22)01585-9", "article-title": "The Lancet Commission on lessons for the future from the COVID-19 pandemic", "author": "Sachs", "doi-asserted-by": "crossref", "first-page": "1224", "journal-title": "Lancet", "key": "R1-20240603", "volume": "400", "year": "2022" }, { "DOI": "10.1007/s11739-020-02393-1", "article-title": "The burden of thrombotic complications in critically ill patients with COVID-19: charting the uncharted", "author": "Landi", "doi-asserted-by": "crossref", "first-page": "893", "journal-title": "Intern Emerg Med", "key": "R2-20240603", "volume": "15", "year": "2020" }, { "DOI": "10.1016/j.ajem.2020.07.045", "article-title": "Temporal trends in out-of-hospital cardiac arrest during the COVID-19 outbreak", "author": "Landi", "doi-asserted-by": "crossref", "first-page": "553", "journal-title": "Am J Emerg Med", "key": "R3-20240603", "volume": "45", "year": "2021" }, { "DOI": "10.2459/JCM.0000000000001556", "article-title": "Edoxaban and/or colchicine in outpatients with COVID-19: rationale and design of the CONVINCE trial", "author": "Landi", "doi-asserted-by": "crossref", "first-page": "920", "journal-title": "J Cardiovasc Med (Hagerstown)", "key": "R4-20240603", "volume": "24", "year": "2023" }, { "DOI": "10.1016/S2352-3026(22)00175-2", "article-title": "Enoxaparin for primary thromboprophylaxis in symptomatic outpatients with COVID-19 (OVID): a randomised, open-label, parallel-group, multicentre, phase 3 trial", "author": "Barco", "doi-asserted-by": "crossref", "first-page": "e585", "journal-title": "Lancet Haematol", "key": "R5-20240603", "volume": "9", "year": "2022" }, { "DOI": "10.1001/jama.2021.17272", "article-title": "Effect of antithrombotic therapy on clinical outcomes in outpatients with clinically stable symptomatic COVID-19: the ACTIV-4B Randomized Clinical Trial", "author": "Connors", "doi-asserted-by": "crossref", "first-page": "1703", "journal-title": "JAMA", "key": "R6-20240603", "volume": "326", "year": "2021" }, { "DOI": "10.1016/S2213-2600(21)00222-8", "article-title": "Colchicine for community-treated patients with COVID-19 (COLCORONA): a phase 3, randomised, double-blinded, adaptive, placebo-controlled, multicentre trial", "author": "Tardif", "doi-asserted-by": "crossref", "first-page": "924", "journal-title": "Lancet Respir Med", "key": "R7-20240603", "volume": "9", "year": "2021" } ], "reference-count": 7, "references-count": 7, "relation": {}, "resource": { "primary": { "URL": "https://journals.lww.com/10.2459/JCM.0000000000001639" } }, "score": 1, "short-title": [], "source": "Crossref", "subject": [], "subtitle": [], "title": "Edoxaban and/or colchicine for patients with coronavirus disease 2019 managed in the out-of-hospital setting (CONVINCE): a randomized clinical trial", "type": "journal-article", "volume": "25" }
Late treatment
is less effective
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