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All Studies   Meta Analysis       

Antiandrogen agents in COVID-19: a meta-analysis of randomized trials

Kotani et al., Minerva Medica, doi:10.23736/S0026-4806.23.08538-5 (date from preprint)
Aug 2022  
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Mortality 60% Improvement Relative Risk Progression 53% Antiandrogens  Kotani et al.  META ANALYSIS c19early.org Favorsantiandrogens Favorscontrol 0 0.5 1 1.5 2+
7th treatment shown to reduce risk in September 2020, now with p = 0.000000056 from 49 studies.
No treatment is 100% effective. Protocols combine treatments.
5,100+ studies for 112 treatments. c19early.org
Meta analysis of 12 studies, showing significantly lower mortality with antiandrogen treatment.
2 meta analyses show significant improvements with antiandrogens for mortality1,2, hospitalization2, recovery2, and progression1.
Currently there are 49 antiandrogens for COVID-19 studies, showing 37% lower mortality [21‑50%], 47% lower ventilation [23‑64%], 36% lower ICU admission [5‑57%], 32% lower hospitalization [11‑48%], and 8% fewer cases [1‑14%].
risk of death, 60.0% lower, RR 0.40, p < 0.001.
risk of progression, 53.0% lower, RR 0.47, p = 0.003.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Kotani et al., 4 Aug 2022, peer-reviewed, 9 authors. Contact: landoni.giovanni@hsr.it.
This PaperAntiandrogensAll
Yuki Kotani
antiandrogen agents reduced mortality at the longest follow-up available (91/946 [9•6%] vs 244/811 [30%]; risk ratio (RR) = 0•40; 95% confidence interval (CI), 0•24-0•66; P = 0•0004; low certainty of evidence; I 2 =59%). Antiandrogen therapy also reduced clinical worsening (125/941 [13%] vs 279/809 [35%]; RR = 0•47; 95% CI, 0•29-0•78; P = 0•003; low certainty of evidence; I 2 =72%). There was no significant difference in the need for invasive mechanical ventilation, admission to the intensive care unit, the need for hospitalization, or thrombotic events between the two treatment groups. Interpretation Antiandrogen therapy reduced mortality and clinical worsening in adult patients with COVID-19.
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