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All Studies   Meta Analysis       

Consequence of Antivirals Versus Standard Care on Clinical Situation in Patients With COVID-19

Alsaraj et al., Infectious Diseases in Clinical Practice, doi:10.1097/IPC.0000000000001336
Jan 2024  
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Mortality -87% Improvement Relative Risk Favipiravir  Alsaraj et al.  LATE TREATMENT  RCT Is late treatment with favipiravir beneficial for COVID-19? RCT 104 patients in Iraq (September 2021 - February 2022) Higher mortality with favipiravir (not stat. sig., p=0.26) c19early.org Alsaraj et al., Infectious Diseases in.., Jan 2024 Favorsfavipiravir Favorscontrol 0 0.5 1 1.5 2+
RCT 156 COVID-19 patients showing higher mortality with favipiravir and remdesivir overall. Favipiravir and remdesivir were more effective when started earlier, however note that Table 10 compares earlier favipiravir/remdesivir+standard care with standard care at any time, which will exaggerate the benefits/harms of earlier/later treatment. The confidence intervals for the Cox results are unusually narrow suggesting a possible error in calculation.
Potential risks of favipiravir include the creation of dangerous variants, and mutagenicity, carcinogenicity, teratogenicity, and embryotoxicity1-5.
This study is excluded in the after exclusion results of meta analysis: potential data issue.
Study covers remdesivir and favipiravir.
risk of death, 87.1% higher, HR 1.87, p = 0.26, treatment 9 of 51 (17.6%), control 5 of 53 (9.4%), adjusted per study, multivariable, Cox proportional hazards, day 30.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Alsaraj et al., 8 Jan 2024, Randomized Controlled Trial, Iraq, peer-reviewed, 6 authors, study period September 2021 - February 2022. Contact: m.n.abed@uomosul.edu.iq.
This PaperFavipiravirAll
Consequence of Antivirals Versus Standard Care on Clinical Situation in Patients With COVID-19
PhD Marwa N Alsaraj, PhD, † ¶ Mohannad E Qazzaz, PhD, ‡ ¶ Mohammed N Abed, PhD Fawaz A Alassaf, PhD,|| ¶ Mohanad A Alfahad, PhD Mahmood H M Jasim
Favipiravir and remdesivir have recently received more clinical interest for the management of COVID-19. The study aimed to explore the effectiveness of favipiravir or remdesivir on the clinical outcome of SARS-CoV-2 patients in comparison with standard care. All patients were given standard care before being randomized into the following 3 groups: standard care group (standard care only), remdesivir group (remdesivir and standard care), and favipiravir group (group 3, favipiravir and standard care). The primary endpoint of the study was time to recovery or the clinical condition of patients on day 14. A total of 156 patients underwent randomization (53 assigned to standard care group, 51 to favipiravir group, and 52 to remdesivir group). The percentage of death in favipiravir and remdesivir groups was higher than those in the standard care group and likewise the liver enzymes. Studying the time to starting therapy showed that early administration of antivirals resulted in lower percentage of mortality. The ratio of hazard for early favipiravir and remdesivir was lower in comparison with those treated with late administration of the same drugs (hazard ratio, 0.62; 95% confidence interval [CI], 0.62-0.73 vs 3.22; 95% CI, 3.21-3.44, respectively, for favipiravir and 0.11; 95% CI, 0.10-0.12 vs 3.44; 95% CI, 3.43-3.55, respectively, for remdesivir). For favipiravir or remdesivir to have more beneficial effects than standard care alone for SARS-CoV-2 patients, they need to be started as early as possible. However, regular monitoring of liver function is required.
References
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Late treatment
is less effective
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