Use of Bromhexine and Hydroxychloroquine for Treatment of COVID-19 Pneumonia

Mežnar et al., NCT04355026, NCT04355026, Jul 2020

Estimated 90 patient bromhexine + HCQ late treatment RCT with results not reported over 5 years after estimated completion.

Bromhexine efficacy may vary depending on the degree of TMPRSS-dependent fusion for different variants1,2.

2 bromhexine RCTs have results missing long after expected3,4
The trials report an estimated total of 304 patients.

Important missing comments or errors? Let us know.

Study covers TMPRSS2 inhibitors, bromhexine, and HCQ.

1. Willett et al., The hyper-transmissible SARS-CoV-2 Omicron variant exhibits significant antigenic change, vaccine escape and a switch in cell entry mechanism, medRxiv, doi:10.1101/2022.01.03.21268111.medrxiv.org, doi.org.

2. Peacock et al., The SARS-CoV-2 variant, Omicron, shows rapid replication in human primary nasal epithelial cultures and efficiently uses the endosomal route of entry, bioRxiv, doi:10.1101/2021.12.31.474653.biorxiv.org, doi.org.

3. Granados-Montiel et al., New prophylaxis regimen for SARS-CoV-2 infection in health professionals with low doses of hydroxychloroquine and bromhexine: a randomised, double-blind placebo clinical trial (ELEVATE Trial), BMJ Open, doi:10.1136/bmjopen-2020-045190.bmj.com, doi.org.

4. Mežnar et al., Use of Bromhexine and Hydroxychloroquine for Treatment of COVID-19 Pneumonia, NCT04355026, clinicaltrials.gov/study/NCT04355026clinicaltrials.gov.

Mežnar et al., 31 Jul 2020, Randomized Controlled Trial, this trial uses multiple treatments in the treatment arm (combined with HCQ) - results of individual treatments may vary, trial NCT04355026 (history).

Late treatment
is less effective