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0 0.5 1 1.5 2+ Mortality 15% Improvement Relative Risk ICU admission -2% Recovery -10% Khamis et al. Favipiravir for COVID-19 RCT LATE TREATMENT Is late treatment with favipiravir+interferon beta-1b beneficial for COVID-19? RCT 89 patients in Oman (June - August 2020) Trial compares with HCQ, results vs. placebo may differ Trial underpowered for serious outcomes Khamis et al., Int. J. Infectious Diseases, doi:10.1016/j.ijid.2020.11.008 Favors favipiravir Favors HCQ
Randomized Controlled Open Label Trial on the Use of Favipiravir Combined with Inhaled Interferon beta-1b in Hospitalized Patients with Moderate to Severe COVID-19 Pneumonia
Khamis et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2020.11.008
Khamis et al., Randomized Controlled Open Label Trial on the Use of Favipiravir Combined with Inhaled Interferon beta-1b in.., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2020.11.008
Nov 2020   Source   PDF  
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Small 89 patient RCT comparing favipiravir and inhaled interferon with HCQ for moderate to severe COVID-19 pneumonia, not finding significant differences. There was no control group. This study is excluded in the after exclusion results of meta analysis: study compares against another treatment showing significant efficacy.
risk of death, 14.8% lower, RR 0.85, p = 1.00, treatment 5 of 44 (11.4%), control 6 of 45 (13.3%), NNT 51.
risk of ICU admission, 2.3% higher, RR 1.02, p = 1.00, treatment 8 of 44 (18.2%), control 8 of 45 (17.8%).
risk of no recovery, 9.6% higher, RR 1.10, p = 0.82, treatment 15 of 44 (34.1%), control 14 of 45 (31.1%).
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Khamis et al., 9 Nov 2020, Randomized Controlled Trial, Oman, peer-reviewed, 11 authors, study period 22 June, 2020 - 13 August, 2020, this trial compares with another treatment - results may be better when compared to placebo, this trial uses multiple treatments in the treatment arm (combined with interferon beta-1b) - results of individual treatments may vary.
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Abstract: International Journal of Infectious Diseases 102 (2021) 538–543 Contents lists available at ScienceDirect International Journal of Infectious Diseases journal homepage: Randomized controlled open label trial on the use of favipiravir combined with inhaled interferon beta-1b in hospitalized patients with moderate to severe COVID-19 pneumonia Faryal Khamisa,* , Hanan Al Naabib , Adil Al Lawatib , Zaiyana Ambusaidib , Mariam Al Sharjic, Umkulthum Al Barwanid , Nenad Pandaka , Zakariya Al Balushia , Maher Al Bahranie , Issa Al Salmif , Ibrahim Al-Zakwanig a Infection Diseases Unit, Department of Medicine, Royal Hospital, Muscat, Oman Acute Medicine Unit, Department of Medicine, Royal Hospital, Muscat, Oman c Department of Nursing, Royal Hospital, Muscat, Oman d Department of Pharmacy, Royal Hospital, Muscat, Oman e Department of Anesthesia and Critical Care, Royal Hospital, Muscat, Oman f Department of Nephrology, Royal Hospital, Muscat, Oman g Department of Pharmacology & Clinical Pharmacy, College of Medicine & Clinical Pharmacy, Sultan Qaboos University, Muscat, Oman b A R T I C L E I N F O A B S T R A C T Article history: Received 21 September 2020 Received in revised form 3 November 2020 Accepted 4 November 2020 Objective: To evaluate the therapeutic effectiveness of favipiravir combined with inhaled interferon beta1b in adult patients hospitalized with moderate to severe COVID-19 pneumonia. Methods: A randomized, open-label controlled trial of oral favipiravir in adults hospitalized with moderate to severe COVID-19 pneumonia from June 22nd 2020 to August 13th 2020 was conducted. Patients were randomly assigned to receive either a combination of favipiravir with interferon beta-1b by inhalation aerosol or hydroxychloroquine (HCQ). The outcome endpoints included improvement in inflammatory markers, lower length of hospital stay (LOS), discharges and lower overall 14-day mortality. Results: A total of 89 patients underwent randomization with 49% (n = 44) assigned to favipiravir and 51% (n = 45) assigned HCQ. The overall mean age was 55  14 years and 58% (n = 52) were males. There were no significant differences in the inflammatory biomarkers at hospital discharge between the two groups; C-reactive protein (p = 0.413), ferritin (p = 0.968), lactate dehydrogenase (p = 0.259) and interleukin 6 (p = 0.410). There were also no significant differences between the two groups with regards to the overall LOS (7 vs 7 days; p = 0.948), transfers to the ICU (18.2% vs 17.8%; p = 0.960), discharges (65.9% vs 68.9%; p = 0.764) and overall mortality (11.4% vs 13.3%; p = 0.778). Conclusions: No differences in clinical outcomes were found between favipiravir plus inhaled interferon beta-1b and hydroxychloroquine in adults hospitalized with moderate to severe COVID-19 pneumonia. © 2020 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license (
Late treatment
is less effective
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