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0 0.5 1 1.5 2+ Mortality -196% Improvement Relative Risk ICU admission 76% Recovery -42% Viral clearance 43% Favipiravir  AlQahtani et al.  LATE TREATMENT  RCT Is late treatment with favipiravir beneficial for COVID-19? RCT 106 patients in Bahrain (August 2020 - March 2021) Lower ICU admission (p=0.2) and worse recovery (p=0.51), not sig. AlQahtani et al., Scientific Reports, Mar 2022 Favors favipiravir Favors control

Randomized controlled trial of favipiravir, hydroxychloroquine, and standard care in patients with mild/moderate COVID-19 disease

AlQahtani et al., Scientific Reports, doi:10.1038/s41598-022-08794-w, NCT04387760
Mar 2022  
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RCT with 54 favipiravir, 51 HCQ, and 52 SOC hospitalized patients in Bahrain, showing no significant differences. Viral clearance improved with both treatments, but did not reach statistical significance with the small sample size.
Study covers HCQ and favipiravir.
risk of death, 196.3% higher, RR 2.96, p = 1.00, treatment 1 of 54 (1.9%), control 0 of 52 (0.0%), continuity correction due to zero event (with reciprocal of the contrasting arm), day 30.
risk of ICU admission, 75.9% lower, RR 0.24, p = 0.20, treatment 1 of 54 (1.9%), control 4 of 52 (7.7%), NNT 17.
risk of no recovery, 41.9% higher, RR 1.42, p = 0.51, treatment 8 of 53 (15.1%), control 5 of 47 (10.6%).
risk of no viral clearance, 42.9% lower, RR 0.57, p = 0.21, treatment 8 of 40 (20.0%), control 14 of 40 (35.0%), NNT 6.7.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
AlQahtani et al., 23 Mar 2022, Randomized Controlled Trial, Bahrain, peer-reviewed, 14 authors, study period August 2020 - March 2021, trial NCT04387760 (history).
This PaperFavipiravirAll
Randomized controlled trial of favipiravir, hydroxychloroquine, and standard care in patients with mild/moderate COVID-19 disease
Manaf Alqahtani, Nitya Kumar, Dhuha Aljawder, Abdulkarim Abdulrahman, Mohammed Wael Mohamed, Fatema Alnashaba, Mohammed Abu Fayyad, Faisal Alshaikh, Fatima Alsahaf, Sawsan Saeed, Amal Almahroos, Zainab Abdulrahim, Sameer Otoom, Stephen L Atkin
Scientific Reports, doi:10.1038/s41598-022-08794-w
Favipiravir has antiviral activity against influenza, West Nile virus, and yellow fever virus and against flaviviruses. The objective of this pilot study was to compare three arms: favipiravir; hydroxychloroquine; standard care (no specific SARS-CoV-2 treatment) only, in symptomatic patients infected by SARS-CoV-2 in an open-labelled randomized clinical trial. The trial was registered with Bahrain National Taskforce for Combatting COVID-19 on the 7th of May 2020 (registration code: NCT04387760). 150 symptomatic patients with COVID-19 disease were randomized into one of three arms: favipiravir, hydroxychloroquine, or standard care only. The primary outcome was the clinical scale at the end of study follow up (day 14 or on discharge/death) based on a points scale. The secondary outcomes were viral clearance, biochemical parameter changes and mortality at 30-days. Baseline characteristics did not differ between groups. The proportion of patients who achieved a clinical scale < 2 did not differ between groups. The favipiravir-treated and hydroxychloroquine-treated group showed increased viral clearance (OR, 95%CI 2.38, 0.83-6.78, OR, 95%CI 2.15, 0.78-5.92, respectively) compared to standard care, but this was not significant. The biochemical profile did not differ between groups, except for the platelet count (P < 0.03) and uric acid (P < 0.004) that were higher with favipiravir-treatment. Primary or secondary outcome measures did not differ between favipiravir, hydroxychloroquine, and standard therapy for mild to moderate COVID-19 disease; therefore, whilst favipiravir therapy appeared safe with a trend to increased viral clearance, there was no superior therapeutic utility. Clinical trials registration. NCT04387760. Registration date: 07/05/2020. Coronavirus disease 2019 (COVID-19 ) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and has developed into a pandemic with serious global public health and economic sequelae. As of May 30th, 2021, more than 170,695,962 million cases have been confirmed worldwide, leading to over 3,550,234 deaths 1 . Several vaccines have been shown to prevent or ameliorate COVID-19 disease, and several are currently developing 2 . However, for those that establish COVID-19 disease, there is a need for effective therapeutic agents to prevent the progressive deterioration that may be seen. There have been several reports of medications, such as remdesivir, with antiviral properties that have shown efficacy with shorter time-to-recovery against SARS-CoV-2 3 . It has been suggested that corticosteroids should be used cautiously unless there is evidence of refractory septic shock, acute respiratory distress syndrome (ARDS), or another compelling indication for their Use 4 . Hydroxychloroquine was thought to show great promise at the time that this study was initiated 5 but, in a large observational study, showed no differences in rates of intubation or death 6 , and a randomized trial..
Author contributions N.K.: data analysis, interpretation and preparation of the manuscript; D.A., A.A., F.A., M.A.F., F.A., F.A., S.S., A.A., Z.A., S.O. & S.A.: conception and design, data collection, manuscript review; S.S., N.K. & S.L.A.: writing and manuscript review; M.A.Q.: conception and design of the study and manuscript review. Competing interests The authors declare no competing interests. Additional information Supplementary Information The online version contains supplementary material available at https:// doi. org/ 10. 1038/ s41598-022-08794-w. Correspondence and requests for materials should be addressed to M.A. Reprints and permissions information is available at Publisher's note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Alqahtani, Randomized controlled trial of convalescent plasma therapy against standard therapy in patients with severe COVID-19 disease, Sci. Rep, doi:10.1038/s41598-021-89444-5
Beigel, Remdesivir for the treatment of Covid-19-preliminary report, N. Engl. J. Med, doi:10.1056/NEJMoa2007764
Birkett, Day, Internal pilot studies for estimating sample size, Stat. Med
Cai, Experimental treatment with favipiravir for COVID-19: An open-label control study, Engineering, doi:10.1016/j.eng.2020.03.007
Corman, Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR, Euro Surveill, doi:10.2807/1560-7917.Es.2020.25.3.2000045
Delang, Abdelnabi, Neyts, Favipiravir as a potential countermeasure against neglected and emerging RNA viruses, Antiviral Res, doi:10.1016/j.antiviral.2018.03.003
Diastolic, None, median (IQR)
Dong, Hu, Gao, Discovering drugs to treat coronavirus disease 2019 (COVID-19), Drug Discover. Therap, doi:10.5582/ddt.2020.01012
Echeverría-Esnal, Azithromycin in the treatment of COVID-19: A review, Expert Rev. Anti Infect. Ther, doi:10.1080/14787210.2020.1813024
Gautret, Clinical and microbiological effect of a combination of hydroxychloroquine and azithromycin in 80 COVID-19 patients with at least a six-day follow up: A pilot observational study, Travel Med. Infect. Dis, doi:10.1016/j.tmaid.2020.101663
Gautret, Hydroxychloroquine and azithromycin as a treatment of COVID-19: Results of an open-label non-randomized clinical trial, Int. J. Antimicrob. Agents, doi:10.1016/j.ijantimicag.2020.105949
Gavriatopoulou, Emerging treatment strategies for COVID-19 infection, Clin. Exp. Med, doi:10.1007/s10238-020-00671-y
Geleris, Observational study of hydroxychloroquine in hospitalized patients with Covid-19, N. Engl. J. Med
Geleris, Observational study of hydroxychloroquine in hospitalized patients with Covid-19, N. Engl. J. Med, doi:10.1056/NEJMoa2012410
Ghazy, A systematic review and meta-analysis on chloroquine and hydroxychloroquine as monotherapy or combined with azithromycin in COVID-19 treatment, Sci. Rep
Hassanipour, The efficacy and safety of Favipiravir in treatment of COVID-19: A systematic review and meta-analysis of clinical trials, Sci. Rep
Mehrotra, Clinical endpoints for evaluating efficacy in COVID-19 vaccine trials, Ann. Intern. Med, doi:10.7326/m20-6169
Mehta, Mazer-Amirshahi, Alkindi, Pourmand, Pharmacotherapy in COVID-19; A narrative review for emergency providers, Am. J. Emerg. Med, doi:10.1016/j.ajem.2020.04.035
Mishima, Anzai, Miyazaki, Abe, Uric acid elevation by favipiravir, an antiviral drug, Tohoku J. Exp. Med, doi:10.1620/tjem.251.87
Mitjà, A cluster-randomized trial of hydroxychloroquine for prevention of Covid-19, N. Engl. J. Med, doi:10.1056/NEJMoa2021801
Murohashi, Outcome of early-stage combination treatment with favipiravir and methylprednisolone for severe COVID-19 pneumonia: A report of 11 cases, Respir. Investig, doi:10.1016/j.resinv.2020.08.001
Néant, Modeling SARS-CoV-2 viral kinetics and association with mortality in hospitalized patients from the French COVID cohort, Proc. Natl. Acad. Sci, doi:10.1073/pnas.2017962118
Rao, Manissero, Steele, Pareja, A systematic review of the clinical utility of cycle threshold values in the context of COVID-19, Infect. Dis. Ther, doi:10.1007/s40121-020-00324-3
Shah, Safety and efficacy of ozone therapy in mild to moderate COVID-19 patients: A phase 1/11 randomized control trial (SEOT study), Int. Immunopharmacol, doi:10.1016/j.intimp.2020.107301
Sreekanth, Lai, Tackling COVID-19 using remdesivir and favipiravir as therapeutic options, Chembiochem Eur. J. Chem. Biol, doi:10.1002/cbic.202000595
Systolic, None, median (IQR
Tang, Hydroxychloroquine in patients with mainly mild to moderate coronavirus disease 2019: Open label, randomised controlled trial, BMJ, doi:10.1136/bmj.m1849
Udwadia, Efficacy and safety of favipiravir, an oral RNA-dependent RNA polymerase inhibitor, in mild-to-moderate COVID-19: A randomized, comparative, open-label, multicenter, phase 3 clinical trial, Int. J. Infect. Dis
Vicenzi, The liaison between respiratory failure and high blood pressure: Evidence from COVID-19 patients, Eur. Respir. J, doi:10.1183/13993003.01157-2020
Vincent, Use of the SOFA score to assess the incidence of organ dysfunction/failure in intensive care units: Results of a multicenter, prospective study. Working group on "sepsis-related problems" of the European Society of Intensive Care Medicine, Crit. Care Med, doi:10.1097/00003246-199811000-00016
Yao, Vitro antiviral activity and projection of optimized dosing design of hydroxychloroquine for the treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Clin. Infect. Dis, doi:10.1093/cid/ciaa237
Yaylaci, The effects of favipiravir on hematological parameters of covıd-19 patients, Rev. Assoc Med. Bras, doi:10.1590/1806-9282.66.S2.65
Late treatment
is less effective
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