RECOVER: Phase 2 Randomized, Double-Blind Trial TREating Hospitalized Patients With COVID-19 With Camostat MesilatE, a TMPRSS2 Inhibitor

Bryce et al., NCT04470544, RECOVER, NCT04470544, Mar 2024
Mortality 25% improvement lower risk ← → higher risk Camostat for COVID-19  RECOVER  LATE TREATMENT RCT Is late treatment with camostat beneficial for COVID-19? Double-blind RCT 100 patients in the USA Trial underpowered to detect differences c19early.org Bryce et al., NCT04470544, March 2024 0 0.5 1 1.5 2+ RR
RCT 100 patients showing no significant difference with camostat. Results are currently unclear - different mortality numbers were provided for all-cause mortality and mortality rate (2/50 vs. 3/46 for the treatment group at 28 days, with the 28 day all-cause mortality result removed in an updated submission). The main outcome measures appear to be different due to only including patients that submitted day 28 outcome data.
Standard of Care (SOC) for COVID-19 in the study country, the USA, is very poor with very low average efficacy for approved treatments1. Only expensive, high-profit treatments were approved for early treatment. Low-cost treatments were excluded, reducing the probability of early treatment due to access and cost barriers, and eliminating complementary and synergistic benefits seen with many low-cost treatments.
Study covers TMPRSS2 inhibitors and camostat.
risk of death, 25.0% lower, RR 0.75, p = 1.00, treatment 3 of 50 (6.0%), control 4 of 50 (8.0%), NNT 50, day 56.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Bryce et al., 28 Mar 2024, Double Blind Randomized Controlled Trial, placebo-controlled, USA, preprint, 1 author, trial NCT04470544 (history) (RECOVER). Contact: Nguyen.Vy@mayo.edu, ClinicalResearch@tmcaz.com, Vimoktayon.Torsak@mayo.edu, Pecenka.Stacey@mayo.edu.
$0 $500 $1,000+ Efficacy vs. cost for COVID-19 treatment protocols c19early.org November 2025 USA Russia Sudan Angola Colombia Kenya Mozambique Vietnam Peru Philippines Spain Brazil Italy France Japan Canada China Uzbekistan Nepal Ethiopia Iran Ghana Mexico South Korea Germany Bangladesh Saudi Arabia Algeria Morocco Yemen Poland India DR Congo Madagascar Thailand Uganda Venezuela Nigeria Egypt Bolivia Taiwan Zambia Fiji Bosnia-Herzegovina Ukraine Côte d'Ivoire Bulgaria Greece Slovakia Singapore Iceland New Zealand Czechia Mongolia Israel Trinidad and Tobago Hong Kong North Macedonia Belarus Qatar Panama Serbia CAR USA favored high-profit treatments.The average efficacy of treatments was very low.High-cost protocols reduce early treatment, andforgo complementary/synergistic benefits. More effective More expensive 75% 50% 25% ≤0%
$0 $500 $1,000+ Efficacy vs. cost for COVID-19treatment protocols worldwide c19early.org November 2025 USA Russia Sudan Angola Colombia Kenya Mozambique Vietnam Peru Philippines Spain Brazil Italy France Japan Canada China Uzbekistan Nepal Ethiopia Iran Ghana Mexico South Korea Germany Bangladesh Saudi Arabia Algeria Morocco Yemen Poland India DR Congo Madagascar Thailand Uganda Venezuela Nigeria Egypt Bolivia Taiwan Zambia Fiji Ukraine Côte d'Ivoire Eritrea Bulgaria Greece Slovakia Singapore New Zealand Malawi Czechia Mongolia Israel Trinidad and Tobago North Macedonia Belarus Qatar Panama Serbia Syria USA favored high-profit treatments.The average efficacy was very low.High-cost protocols reduce early treatment,and forgo complementary/synergistic benefits. More effective More expensive 75% 50% 25% ≤0%
Late treatment
is less effective
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