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All Studies   Meta Analysis       

5α-Reductase Inhibitors Are Associated with Reduced Risk of SARS-CoV-2 Infection: A Matched-Pair, Registry-Based Analysis

Lyon et al., Journal of Urology, doi:10.1097/JU.0000000000002180
Jan 2022  
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Mortality 17% Improvement Relative Risk Case 7% Antiandrogens for COVID-19  Lyon et al.  Prophylaxis Is prophylaxis with antiandrogens beneficial for COVID-19? Retrospective 1,938 patients in the USA (March 2020 - February 2021) Fewer cases with antiandrogens (p=0.042) c19early.org Lyon et al., J. Urology, January 2022 Favorsvarious 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.
5,300+ studies for 116 treatments. c19early.org
Retrospective 944 5ARI users in the USA and 944 matched controls, showing lower risk of COVID-19 cases with treatment.
Standard of Care (SOC): SOC for COVID-19 in the study country, the USA, is very poor with very low average efficacy for approved treatments1. Only expensive, high-profit treatments were approved. Low-cost treatments were excluded, reducing the probability of treatment—especially early—due to access and cost barriers, and eliminating complementary and synergistic benefits seen with many low-cost treatments.
risk of death, 16.9% lower, RR 0.83, p = 0.61, treatment 15 of 944 (1.6%), control 19 of 994 (1.9%), NNT 310.
risk of case, 7.2% lower, RR 0.93, p = 0.04, treatment 399 of 944 (42.3%), control 446 of 994 (44.9%), NNT 38, adjusted per study, odds ratio converted to relative risk, multivariable.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Lyon et al., 31 Jan 2022, retrospective, USA, peer-reviewed, 8 authors, study period 8 March, 2020 - 15 February, 2021.
This PaperAntiandrogensAll
DOI record: { "DOI": "10.1097/ju.0000000000002180", "ISSN": [ "0022-5347", "1527-3792" ], "URL": "http://dx.doi.org/10.1097/ju.0000000000002180", "alternative-id": [ "10.1097/JU.0000000000002180" ], "author": [ { "affiliation": [ { "name": "Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio" } ], "family": "Lyon", "given": "Madison", "sequence": "first" }, { "affiliation": [ { "name": "Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio" } ], "family": "Li", "given": "Jianbo", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio" } ], "family": "Cullen", "given": "Jennifer", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio" } ], "family": "Milinovich", "given": "Alex", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio" } ], "family": "Kattan", "given": "Michael", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Neurology, Neurological Institute, Cleveland Clinic, Cleveland, Ohio" } ], "family": "Jehi", "given": "Lara", "sequence": "additional" }, { "affiliation": [ { "name": "Genitourinary Malignancies Research Center, Department of Cancer Biology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio" } ], "family": "Sharifi", "given": "Nima", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio" } ], "family": "Klein", "given": "Eric A.", "sequence": "additional" } ], "container-title": [ "Journal of Urology" ], "content-domain": { "crossmark-restriction": false, "domain": [] }, "created": { "date-parts": [ [ 2021, 8, 26 ] ], "date-time": "2021-08-26T08:00:48Z", "timestamp": 1629964848000 }, "deposited": { "date-parts": [ [ 2022, 3, 25 ] ], "date-time": "2022-03-25T00:29:55Z", "timestamp": 1648168195000 }, "indexed": { "date-parts": [ [ 2022, 3, 25 ] ], "date-time": "2022-03-25T01:14:45Z", "timestamp": 1648170885055 }, "is-referenced-by-count": 2, "issn-type": [ { "type": "print", "value": "0022-5347" }, { "type": "electronic", "value": "1527-3792" } ], "issue": "1", "issued": { "date-parts": [ [ 2022, 1 ] ] }, "journal-issue": { "issue": "1", "published-print": { "date-parts": [ [ 2022, 1 ] ] } }, "language": "en", "member": "276", "original-title": [], "page": "183-189", "prefix": "10.1097", "published": { "date-parts": [ [ 2022, 1 ] ] }, "published-print": { "date-parts": [ [ 2022, 1 ] ] }, "publisher": "Ovid Technologies (Wolters Kluwer Health)", "reference-count": 0, "references-count": 0, "relation": {}, "resource": { "primary": { "URL": "http://www.jurology.com/doi/10.1097/JU.0000000000002180" } }, "score": 1, "short-container-title": [ "Journal of Urology" ], "short-title": [], "source": "Crossref", "subject": [ "Urology" ], "subtitle": [], "title": [ "5α-Reductase Inhibitors Are Associated with Reduced Risk of SARS-CoV-2 Infection: A Matched-Pair, Registry-Based Analysis" ], "type": "journal-article", "volume": "207" }
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