A Randomised Phase II Trial in Early COVID-19, Assessing Use of Camostat by Blocking SARS-CoV-2 Spike Protein-initiated Membrane Fusion

Dhaliwal et al., NCT04455815, SPIKE-1, NCT04455815, Mar 2022
Hospitalization 14% improvement lower risk ← → higher risk Camostat for COVID-19  SPIKE-1  EARLY TREATMENT RCT Is early treatment with camostat beneficial for COVID-19? RCT 34 patients in the United Kingdom Trial underpowered to detect differences c19early.org Dhaliwal et al., NCT04455815, March 2022 0 0.5 1 1.5 2+ RR
Early terminated RCT with 34 patients showing no significant differences with camostat treatment.
Standard of Care (SOC) for COVID-19 in the study country, the United Kingdom, is very poor with very low average efficacy for approved treatments1. The United Kingdom focused on expensive high-profit treatments, approving only one low-cost early treatment, which required a prescription and had limited adoption. The high-cost prescription treatment strategy reduces the probability of early treatment due to access and cost barriers, and eliminates complementary and synergistic benefits seen with many low-cost treatments.
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Study covers TMPRSS2 inhibitors and camostat.
risk of hospitalization, 14.3% lower, RR 0.86, p = 1.00, treatment 2 of 14 (14.3%), control 3 of 18 (16.7%), NNT 42.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Dhaliwal et al., 3 Mar 2022, Randomized Controlled Trial, United Kingdom, preprint, 1 author, trial NCT04455815 (history) (SPIKE-1).
$0 $500 $1,000+ Efficacy vs. cost for COVID-19 treatment protocols c19early.org September 2026 United Kingdom Angola Colombia Kenya Mozambique Myanmar South Africa Peru Philippines USA Brazil France Italy Canada Pakistan Spain Vietnam Japan Nepal Iran Bangladesh Ethiopia Ghana Mexico South Korea Saudi Arabia Algeria Morocco Yemen Poland Uzbekistan India China Venezuela DR Congo Madagascar Thailand Uganda Egypt Nigeria Taiwan Fiji Zambia Bosnia-Herzegovina Dominican Republic Bolivia Côte d'Ivoire Eritrea Togo Iceland New Zealand Mongolia Czechia Belarus Israel Haiti North Macedonia Hong Kong Qatar Panama Serbia The United Kingdom favored high-profit treatments.The average efficacy of treatments was moderate.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 September 2026 United Kingdom Angola Colombia Kenya Mozambique Myanmar South Africa Peru Philippines USA Brazil France Italy Canada Pakistan Spain Vietnam Japan Iran Bangladesh Ethiopia Ghana Mexico South Korea Saudi Arabia Algeria Morocco Yemen Poland Uzbekistan India China Venezuela DR Congo Madagascar Thailand Uganda Egypt Taiwan Fiji Zambia Dominican Rep. Bolivia Côte d'Ivoire Eritrea Mongolia Czechia Belarus Israel North Macedonia Hong Kong Qatar Panama Serbia The UK favored high-profit treatments.The average efficacy was moderate.High-cost protocols reduce early treatment,and forgo complementary/synergistic benefits. More effective More expensive 75% 50% 25% ≤0%
Please send us corrections, updates, or comments. c19early involves the extraction of 200,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. IMA and WCH provide treatment protocols.
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