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0 0.5 1 1.5 2+ Progression 51% Improvement Relative Risk Recovery 8% Andrographolide  Kanokkangsadal et al.  EARLY TREATMENT  DB RCT Is early treatment with andrographolide beneficial for COVID-19? Double-blind RCT 165 patients in Thailand (July - September 2021) Lower progression with andrographolide (not stat. sig., p=0.25) Kanokkangsadal et al., Research in Pha.., Nov 2023 Favors andrographolide Favors control

Andrographis paniculata extract versus placebo in the treatment of COVID-19: a double-blinded randomized control trial

Kanokkangsadal et al., Research in Pharmaceutical Sciences, doi:10.4103/1735-5362.389947, TCTR20210809004
Nov 2023  
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RCT 165 low-risk mild COVID-19 patients in Thailand receiving either 180mg/day of Andrographis paniculata extract or placebo for 5 days. No significant difference was found between groups for disease progression, though A. paniculata showed lower progression. Most symptoms improved similarly between groups, though A. paniculata provided faster relief for headaches and loss of smell. All patients recovered with 14 days. The main side effect was mild diarrhea.
risk of progression, 50.6% lower, RR 0.49, p = 0.25, treatment 4 of 83 (4.8%), control 8 of 82 (9.8%), NNT 20.
risk of no recovery, 8.4% lower, RR 0.92, p = 0.33, treatment 64 of 83 (77.1%), control 69 of 82 (84.1%), NNT 14, total recovery, day 5.
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Kanokkangsadal et al., 23 Nov 2023, Double Blind Randomized Controlled Trial, placebo-controlled, Thailand, peer-reviewed, 9 authors, study period July 2021 - September 2021, trial TCTR20210809004. Contact:
This PaperAndrographol..All
Andrographis paniculata extract versus placebo in the treatment of COVID-19: a double-blinded randomized control trial
Arunporn Itharat, Puritat Kanokkangsadal, Chatchai Mingmalairak, Nichamon Mukkasombat, Pranporn Kuropakornpong, Patsorn Worawattananutai, Thana Khawcharoenporn, Intouch Sakpakdeejaroen, Neal M Davies
Background and purpose: Andrographis paniculata (Burm.f.) Nees has been recommended to relieve symptoms and decrease the severity of COVID-19. The clinical study aimed to investigate the efficacy and safety of A. paniculata ethanolic extract (APE). Experimental approach: The efficacy and safety of APE in asymptomatic or mildly symptomatic COVID-19 patients compared with placebo were investigated through a prospective, double-blind randomized control trial. Patients received APE containing 60 mg of andrographolide, three times a day for five days. WHO progression scale, COVID-19 symptoms, and global assessment evaluated the efficacy and adverse events, liver and renal functions were monitored for safety. Findings/Results: 165 patients completed the study (83 patients in the APE group and 82 patients in the placebo group). The highest WHO progression scale was 4 and COVID-19 symptoms were significantly relieved on the last day of intervention in both groups, with no significant difference between groups. APE significantly relieved headache symptoms on day 1 and olfactory loss symptoms on day 2 compared to placebo. The global assessment showed that 80.7% of patients had total recovery after 5-day treatment with APE. Mild diarrhea was the most common side effect with a high dose that resolved within a few days. No hepatic or renal toxicity was associated with treatment. Conclusion and implications: APE at 180 mg/day for 5 days did not reduce COVID-19 progression in asymptomatic or mildly afflicted COVID-19 patients, however, it shortened the symptoms of olfactory loss with no adverse effects over 5 days of use.
The Andrographolide used for COVID -19 treatment The Andrographolide used for COVID-19 treatment Conflicts of interest statement The authors declared no conflict of interest in this study. Authors' contributions
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