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All Studies   Meta Analysis    Recent:   
0 0.5 1 1.5 2+ Mortality 55% Improvement Relative Risk Ventilation 34% ICU admission 19% Recovery 47% Spironolactone  Abbasi et al.  LATE TREATMENT  RCT Is late treatment with spironolactone beneficial for COVID-19? RCT 138 patients in Iran (December 2020 - April 2021) Improved recovery with spironolactone (p=0.000059) c19early.org Abbasi et al., J. the Endocrine Society, Feb 2022 Favors spironolactone Favors control

A Randomized Trial of Sitagliptin and Spironolactone With Combination Therapy in Hospitalized Adults With COVID-19

Abbasi et al., Journal of the Endocrine Society, doi:10.1210/jendso/bvac017
Feb 2022  
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33rd treatment shown to reduce risk in February 2022
 
*, now known with p = 0.00046 from 12 studies.
Lower risk for mortality, progression, and recovery.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
3,900+ studies for 60+ treatments. c19early.org
RCT including 51 spironolactone patients and 87 control patients in Iran, showing improved recovery with spironolactone, sitagliptin, and the combination of both.
risk of death, 55.1% lower, RR 0.45, p = 0.10, treatment 5 of 51 (9.8%), control 19 of 87 (21.8%), NNT 8.3, day 5.
risk of mechanical ventilation, 33.7% lower, RR 0.66, p = 0.36, treatment 7 of 51 (13.7%), control 18 of 87 (20.7%), NNT 14, day 5.
risk of ICU admission, 18.8% lower, RR 0.81, p = 0.67, treatment 10 of 51 (19.6%), control 21 of 87 (24.1%), NNT 22, day 5.
risk of no recovery, 47.3% lower, RR 0.53, p < 0.001, treatment mean 1.64 (±0.81) n=51, control mean 3.11 (±2.45) n=87, relative clinical score, day 5.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Abbasi et al., 7 Feb 2022, Single Blind Randomized Controlled Trial, Iran, peer-reviewed, 11 authors, study period December 2020 - April 2021.
This PaperSpironolactoneAll
A Randomized Trial of Sitagliptin and Spironolactone With Combination Therapy in Hospitalized Adults With COVID-19
Farhad Abbasi, Reuben Adatorwovor, Mohammad Ali Davarpanah, Yasaman Mansoori, Mehdi Hajiani, Farzan Azodi, Sepideh Sefidbakht, Shayesteh Davoudi, Farzana Rezaei, Shayan Mohammadmoradi, MD Kamyar Asadipooya
Journal of the Endocrine Society, doi:10.1210/jendso/bvac017
Context: COVID-19 may cause respiratory distress syndrome and death. Treatment of COVID-19 to prevent complications remains a priority. Objective: Our investigation sought to determine whether combination of spironolactone and sitagliptin could reduce mortality for inpatients with SARS-CoV-2 infection. Methods: This single-blind, 4-arm, prospective randomized clinical trial was conducted at Shiraz and Bushehr University of Medical Sciences hospitals between December 2020 and April 2021. We randomized hospitalized adult patients with COVID-19 pneumonia into 4 groups: control, combination therapy, sitagliptin add-on, or spironolactone add-on. The primary outcome was the clinical improvement of the patients in the hospital as measured on an 8-point numerical scale. The secondary outcomes included intubation, ICU admission, end organ damages, CT findings, and paraclinical information. Results: A total of 263 admitted patients were randomly assigned to control group (87 patients), combination group (60 patients), sitagliptin group (66 patients), and spironolactone group (50 patients). There were no significant differences in baseline characteristics, except for higher age in control group. The intervention groups, especially combination therapy, had better clinical outcomes (clinical score on fifth day of admission: 3.11 ± 2.45 for controls, 1.33 ± 0.50 for combination, 1.68 ± 1.02 for sitagliptin, and 1.64 ± 0.81 for spironolactone; P = 0.004). However, the mortality rate was lower in patients who received spironolactone (21.84% control, 13.33% combination, 13.64% sitagliptin, 10.00% spironolactone; P = 0.275). Our intervention reduced lung infiltration but not the area of involvement in lungs. Conclusion: Sitagliptin and spironolactone can potentially improve clinical outcomes of hospitalized COVID-19 patients.
Abbreviations: CT, computed tomography; ECMO, extracorporeal membrane oxygenation; PCR, polymerase chain reaction. Financial Support This project is supported by Vice-Chancellor for Research at the Shiraz University of Medical Sciences, Bushehr University Medical Sciences, Faghihi Hospital and Shohadaye_Khalije_ Fars Hospital. Author Contributions Kamyar Asadipooya proposed the idea, designed the study, and wrote the manuscript. Farhad Abbasi and Mohammad Ali Davarpanah helped designi the study. Reuben Adatorwovor provided statistical analysis, wrote the statistical portions, and revised the manuscript. Sepideh Sefidbakht and Farhad abbasi read the CT scan results. Yasaman Mansoori, Mehdi Hajiani, Farzan Azodi, Shayesteh Davoudi, and Farzana Rezaei collected the data. Shayan Mohammadmoradi helped with designing the study and editing the manuscript. All authors approved the final version of the manuscript. Disclosures The authors have declared that no conflict of interest exists. Iranian Registry of Clinical Trial Information Iranian Registry of Clinical Trial registration number: IRCT20201003048904N2; registration date: December 10, 2020.
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Late treatment
is less effective
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