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Nitazoxanide for COVID-19
14 studies from 193 scientists
3,632 patients in 7 countries
Statistically significant lower risk for ventilation and hospitalization.
8 studies from 7 independent teams in 4 countries show significant improvements.
COVID-19 Nitazoxanide studies. Jul 2024.
0 0.5 1 1.5+ All studies 35% With exclusions 44% Mortality 42% Hospitalization 61% Recovery 6% Cases 13% Viral clearance 38% RCTs 17% RCT mortality 28% Prophylaxis 44% Early 29% Late 12% Favorsnitazoxanide Favorscontrol
Jun 26
Romark, NCT04359680 Trial to Evaluate the Efficacy and Safety of Nitazoxanide (NTZ) for Pre- and Post Exposure Prophylaxis of COVID-19 and Other Viral Respiratory Illnesses (VRI) in Healthcare Workers and Others at Increased Risk of SARS-CoV-2 Infection
43% lower progression (p=0.02), 50% faster recovery (p=0.1), and 3% fewer cases (p=1). RCT 1,407 healthcare workers and others at high risk of SARS-CoV-2 exposure, showing no difference in COVID-19 cases (13 in each group). There was lower symptom severity for nitazoxanide and a trend towards shorter illness duration. There..
Apr 30
Brechot et al., Medical Research Archives, doi:10.18103/mra.v12i4.5252 Nitazoxanide in the Treatment of COVID-19: A paradigm for Antiviral Drugs Targeting Host-Infected Cells
Review of nitazoxanide as a potential treatment for COVID-19. Authors highlight nitazoxanide's unique mechanism of action, which involves inhibiting mitochondrial oxidative phosphorylation in host cells, thereby lowering cellular ATP cont..
Apr 12
Corral et al., Global Journal of Aging & Geriatric Research, doi:10.33552/GJAGR.2024.03.000557 Early Treatment Outcomes of SARS-Cov-2 with Ivermectin, Nitazoxanide and Acetylsalicylic Acid in 2 Nursing Homes During The COVID-19 Pandemic in Cali, Colombia
Retrospective 475 nursing home residents showing low mortality with early treatment using ivermectin, nitazoxanide, and acetylsalicylic acid. All residents were treated when the first positive cases were identified. 87 residents tested po..
Apr 3
Xu et al., Antimicrobial Agents and Chemotherapy, doi:10.1128/aac.01015-23 Two-way pharmacodynamic modeling of drug combinations and its application to pairs of repurposed Ebola and SARS-CoV-2 agents
In Silico study supporting the synergistic combination of nitazoxanide and remdesivir for SARS-CoV-2. Authors developed a two-way pharmacodynamic modeling approach to capture the concentration-dependent drug-drug interactions and combined..
Nov 3
Weng et al., Expert Review of Anti-infective Therapy, doi:10.1080/14787210.2022.2142117 Clinical outcomes, virological efficacy and safety of nitazoxanide in the treatment of patients with COVID-19: a systematic review and meta-analysis of randomized controlled trials
Meta analysis of 5 RCTs showing improved viral clearance with nitazoxanide. Mortality was lower, but without statistical significance.
Nov 1
Chandiwana et al., eBioMedicine, doi:10.1016/j.ebiom.2022.104322 Safety and efficacy of four drug regimens versus standard-of-care for the treatment of symptomatic outpatients with COVID-19: A randomised, open-label, multi-arm, phase 2 clinical trial
13% higher progression (p=0.89), 23% slower recovery (p=0.42), and 67% worse viral clearance (p=0.13). Very high COI low-risk patient RCT in South Africa, showing no significant differences with favipiravir plus nitazoxanide. There were no deaths and no COVID-19 hospitalizations for favipiravir plus nitazoxanide. More patients were seropos..
Oct 31
Abuelazm et al., Clinical Drug Investigation, doi:10.1007/s40261-022-01213-y The Effect of Nitazoxanide on the Clinical Outcomes in Patients with COVID-19: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Systematic review and meta analysis of 6 RCTs, showing significantly improved viral clearance and lower oxygen requirements with nitazoxanide, but no significant differences for mortality, ICU admission, and recovery.
Aug 12
Sokhela et al., Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkac266 Randomized clinical trial of nitazoxanide or sofosbuvir/daclatasvir for the prevention of SARS-CoV-2 infection
66% lower mortality (p=1), 79% lower hospitalization (p=0.5), 17% fewer symptomatic cases (p=0.49), and 21% more cases (p=0.67). Prophylaxis RCT 828 high-risk participants in South Africa, showing no significant difference with nitazoxanide and sofosbuvir/daclatasvir treatment. FLU-PRO results were available for 74% of the nitazoxanide arm compared to 54% of the co..
May 6
Medhat et al., Arab Journal of Gastroenterology, doi:10.1016/j.ajg.2022.04.005 Sofosbuvir/Ledipasvir in Combination or Nitazoxanide Alone are Safe and Efficient Treatments for COVID-19 Infection: A Randomized Controlled Trial for Repurposing antivirals
56% improved viral clearance (p=0.02). RCT with 77 nitazoxanide, 70 sofosbuvir/ledipasvir, and 73 SOC patients in Egypt, showing faster viral clearance with nitazoxanide and with sofosbuvir/ledipasvir. There was no mortality or progression to severe COVID-19 or ICU admission. ..
Apr 13
Rocco et al., Frontiers in Medicine, doi:10.3389/fmed.2022.844728 Nitazoxanide in Patients Hospitalized With COVID-19 Pneumonia: A Multicentre, Randomized, Double-Blind, Placebo-Controlled Trial
5% higher mortality (p=0.95), 31% lower ICU admission (p=0.18), 40% lower need for oxygen therapy (p=0.06), and 64% faster improvement (p<0.0001). RCT late stage patients with COVID-19 pneumonia, 202 treated with nitazoxanide and 203 placebo patients, showing improved recovery, but no significant difference in mortality.
Apr 7
Riccio et al., Cellular and Molecular Life Sciences, doi:10.1007/s00018-022-04246-w Impairment of SARS-CoV-2 spike glycoprotein maturation and fusion activity by nitazoxanide: an effect independent of spike variants emergence
In Vitro study showing that the host-directed broad-spectrum antiviral drug nitazoxanide may be effective for COVID-19 by hampering spike protein maturation and fusion activity. Authors note efficacy across alpha, beta, gamma and delta va..
Feb 28
ANTICOV, News ANTICOV Trial Finds Nitazoxanide/Ciclesonide Drug Combination Does Not Reduce Hospitalisation Risk in Patients With Mild COVID-19
188% higher progression (p=0.04). RCT with 462 nitazoxanide/ciclesonide and 443 paracetamol patients, up to 7 days from onset, showing no significant difference in progression. Minimal details, with the primary mortality outcome and treatment delay not being reported.
Feb 9
Miorin et al., bioRxiv, doi:10.1101/2022.02.08.479634 The oral drug nitazoxanide restricts SARS-CoV-2 infection and attenuates disease pathogenesis in Syrian hamsters
Syrian hamster study showing improvements in SARS-CoV-2 related weight loss, inflammation, viral load, and lung synctia formation with nitazoxanide, and an In Vitro study showing that nitazoxanide inhibits SARS-CoV-2 in H9, iAT2, Vero E6,..
Feb 4
Fowotade et al., medRxiv, doi:10.1101/2022.02.03.22270152 Efficacy and safety of nitazoxanide combined with ritonavir-boosted atazanavir for the treatment of mild to moderate COVID-19
11% worse recovery (p=0.73) and 5% improved viral clearance (p=0.92). Small RCT in Nigeria with 31 nitazoxanide and atazanavir/ritonavir patients, and 26 control patients, showing no significant differences with treatment. 4 treatment group patients discontinued treatment due to the size of the tablets. Tim..
Nov 23
Calderón et al., PAMJ - Clinical Medicine, doi:10.11604/pamj-cm.2021.7.15.30981 Treatment with hydroxychloroquine vs nitazoxanide in patients with COVID-19: brief report
68% lower mortality (p=0.38), 87% lower ventilation (p=0.15), 59% lower ICU admission (p<0.0001), and 52% shorter hospitalization (p=0.007). Planned RCT of HCQ vs. HCQ+nitazoxanide which was aborted due to the retracted Surgisphere paper. Authors retrospectively analyze a small set of HCQ vs. nitazoxanide patients (which were protocol deviations in the planned RCT), showing re..
Sep 11
Walker et al., Clinical Pharmacology & Therapeutics, doi:10.1002/cpt.2463 (date from preprint) An open label, adaptive, phase 1 trial of high-dose oral nitazoxanide in healthy volunteers: an antiviral candidate for SARS-CoV-2
Phase I trial of high dose nitazoxanide, 1500mg twice daily, with 14 participants. Treatment was safe and well tolerated. PBPK predictions were confirmed on day 1 but with underprediction at day 5. Median Cmin was above the in vitro targe..
Aug 10
Calderón et al., News Report Mantiene Hospital Mónica Pretelini bajo índice de muertes Covid de mujeres embarazadas
News report on the use of nitazoxanide for pregnant COVID-19 patients in a clinic in Mexico, reporting significant improvements in hospitalization and mortality compared to locations without treatment.
May 13
Enríquez López et al., Cureus, doi:10.7759/cureus.15002 Evolution of COVID-19 Pregnancies Treated With Nitazoxanide in a Third-Level Hospital
Case study of 51 COVID-19 positive pregnant women in Mexico treated with nitazoxanide, showing much better survival compared to hospitals not using nitazoxanide.
Mar 31
Rossignol et al., eClinicalMedicine, doi:10.1016/j.eclinm.2022.101310 (date from preprint) A randomized double-blind placebo-controlled clinical trial of nitazoxanide for treatment of mild or moderate COVID-19
79% lower hospitalization (p=0.22), 85% lower severe cases (p=0.07), and 7% slower recovery (p=0.88). RCT with 184 outpatients treated with an extended release formulation of nitazoxanide, and 195 controls, showing lower hospitalization and progression to severe disease with treatment. There was one COVID-19 related death in the treatment..
Mar 5
Silva et al., Medical Research Archives, doi:10.18103/mra.v11i2.3364 (date from preprint) Efficacy of Nitazoxanide in reducing the viral load in COVID-19 patients. Randomized, placebo-controlled, single-blinded, parallel group, pilot study
26% improved viral clearance (p=0.36). Small RCT with 23 nitazoxanide and 13 control patients showing significantly more patients achieved over 35% reduction in viral load from baseline. NCT04463264.
Feb 16
Elalfy et al., J. Med. Virol., doi:10.1002/jmv.26880 Effect of a combination of Nitazoxanide, Ribavirin and Ivermectin plus zinc supplement (MANS.NRIZ study) on the clearance of mild COVID-1
87% improved viral clearance (p<0.0001). Non-randomized controlled trial with 62 mild and early moderate patients with home treatment with ivermectin + nitazoxanide + ribavirin + zinc, showing significantly faster viral clearance.
Jan 22
Blum et al., eClinicalMedicine, doi:10.1016/j.eclinm.2021.100981 (date from preprint) Nitazoxanide superiority to placebo to treat moderate COVID-19 – A Pilot prove of concept randomized double-blind clinical trial
67% lower mortality (p=0.25), 62% lower ventilation (p=0.17), 20% lower severe cases, and 56% shorter hospitalization (p=0.02). RCT with 25 nitazoxanide patients and 25 control patients, showing improved virological and clinical outcomes with treatment. Authors also perform an in vitro study in Vero E6 cells showing 90% inhibition with 0.5µM, with no cytotoxicity...
Nov 4
Cadegiani et al., New Microbes and New Infections, doi:10.1016/j.nmni.2021.100915 (date from preprint) Early COVID-19 Therapy with azithromycin plus nitazoxanide, ivermectin or hydroxychloroquine in Outpatient Settings Significantly Improved COVID-19 outcomes compared to Known outcomes in untreated patients
88% lower mortality (p=0.08), 97% lower ventilation (p<0.0001), and 99% lower hospitalization (p<0.0001). Comparison of HCQ, nitazoxanide, and ivermectin showing similar effectiveness for overall clinical outcomes in COVID-19 when used before seven days of symptoms, and overwhelmingly superior compared to the untreated COVID-19 population, ev..
Oct 23
Rocco et al., European Respiratory Journal, doi:10.1183/13993003.03725-2020 (date from preprint) Early use of nitazoxanide in mild Covid-19 disease: randomized, placebo-controlled trial (preprint 10/23)
404% higher ICU admission (p=0.24), 2% higher hospitalization (p=1), 16% worse recovery (p=0.37), and 12% improved viral clearance (p=0.006). RCT 392 patients, median treatment delay 5 days, showing improved viral recovery at 5 days. Symptom recovery was no different at 5 days, and the treatment arm had two ICU admissions compared to zero for control. There were no serious adve..
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