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0 0.5 1 1.5 2+ Mortality 17% Improvement Relative Risk ICU admission 11% TFS score 30% Potassium canrenoate  Kotfis et al.  LATE TREATMENT  RCT Is late treatment with antiandrogens beneficial for COVID-19? RCT 49 patients in Poland (December 2020 - August 2021) Improved recovery with antiandrogens (not stat. sig., p=0.51) Kotfis et al., Pharmaceuticals, February 2022 Favors potassium canrenoate Favors control

Mineralocorticoid Receptor Antagonist (Potassium Canrenoate) Does Not Influence Outcome in the Treatment of COVID-19-Associated Pneumonia and Fibrosis—A Randomized Placebo Controlled Clinical Trial

Kotfis et al., Pharmaceuticals, doi:10.3390/ph15020200, NCT04912011
Feb 2022  
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5th treatment shown to reduce risk in August 2020
*, now known with p = 0.000000056 from 49 studies.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,000+ studies for 60+ treatments.
RCT with 24 patients treated with potassium canrenoate and 25 placebo patients in Poland, showing no significant differences.
risk of death, 16.7% lower, RR 0.83, p = 1.00, treatment 4 of 24 (16.7%), control 5 of 25 (20.0%), NNT 30.
risk of ICU admission, 10.7% lower, RR 0.89, p = 1.00, treatment 6 of 24 (25.0%), control 7 of 25 (28.0%), NNT 33.
relative TFS score, 30.4% better, RR 0.70, p = 0.51, treatment 24, control 25.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Kotfis et al., 5 Feb 2022, Randomized Controlled Trial, placebo-controlled, Poland, peer-reviewed, 10 authors, study period December 2020 - August 2021, trial NCT04912011 (history). Contact: (corresponding author),,,,,,,,,
This PaperAntiandrogensAll
Mineralocorticoid Receptor Antagonist (Potassium Canrenoate) Does Not Influence Outcome in the Treatment of COVID-19-Associated Pneumonia and Fibrosis—A Randomized Placebo Controlled Clinical Trial
Katarzyna Kotfis, Igor Karolak, Kacper Lechowicz, Małgorzata Zegan-Barańska, Agnieszka Pikulska, Paulina Niedźwiedzka-Rystwej, Miłosz Kawa, Jerzy Sieńko, Aleksandra Szylińska, Magda Wiśniewska
Pharmaceuticals, doi:10.3390/ph15020200
In December 2019 the SARS-CoV-2 virus appeared in the world, mainly presenting as an acute infection of the lower respiratory tract, namely pneumonia. Nearly 10% of all patients show significant pulmonary fibrotic changes after the infection. The aim of this study was to evaluate the effectiveness and safety of potassium canrenoate in the treatment of COVID-19-associated pneumonia and pulmonary fibrosis. We performed a randomized clinical trial (RCT) of potassium canrenoate vs placebo. A total of 55 patients were randomized and 49 were included in the final analysis (24 allocated to the intervention group and 25 allocated to the control group). Patients were assessed by physical examination, lung ultrasound, CT imaging and blood samples that underwent biochemical analysis. This RCT has shown that the administration of potassium canrenoate to patients with COVID-19 induced pneumonia was not associated with shorter mechanical ventilation time, shorter passive oxygenation, shorter length of hospitalization or less fibrotic changes on CT imaging. The overall mortality rate was not significantly different between the two groups. Adverse events recorded in this study were not significantly increased by the administration of potassium canrenoate. The negative outcome of the study may be associated with the relatively small number of patients included. Any possible benefits from the use of potassium canrenoate as an antifibrotic drug in COVID-19 patients require further investigation.
Author Contributions: Conceptualization, K.K. and J.S.; Data curation, I.K., M.K. and A.S.; Formal analysis, K.K., I.K., K.L., P.N.-R., M.K. and A.S.; Funding acquisition, K.K. and M.W.; Investigation, K.K., I.K., M.Z.-B. and M.K.; Methodology, K.K., I.K., K.L., A.P., P.N.-R., J.S., A.S. and M.W.; Project administration, K.K. and I.K.; Resources, K.K.; Software, I.K. and K.L.; Supervision, K.K. and A.S.; Validation, M.Z.-B., A.P., P.N.-R. and M.W.; Visualization, I.K. and A.S.; Writing-original draft, K.K., I.K. and A.S.; Writing-review and editing, K.L., M.Z.-B., A.P., P.N.-R., M.K., J.S. and M.W. All authors have read and agreed to the published version of the manuscript. Conflicts of Interest: The authors declare no conflict of interest.
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Late treatment
is less effective
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