A Multicentre, Open Label, Randomised, Controlled, Basket, Pragmatic, Phase II, Clinical and Translational Study to Determine the Efficacy and Safety of Plitidepsin Versus Control in Immunocompromised Adult Patients With Symptomatic COVID-19 Requiring Hospital Care

PharmaMar, NCT05705167, NEREIDA, NCT05705167, Dec 2024
Mortality -36% improvement lower risk ← → higher risk Mortality, day 30 25% Plitidepsin  NEREIDA  LATE TREATMENT RCT Is late treatment with plitidepsin beneficial for COVID-19? RCT 37 patients in Belgium Trial underpowered to detect differences c19early.org PharmaMar, NCT05705167, December 2024 0 0.5 1 1.5 2+ RR
RCT 37 hospitalized immunocompromised patients, showing no significant benefit with plitidepsin treatment.
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risk of death, 36.4% higher, RR 1.36, p = 1.00, treatment 5 of 22 (22.7%), control 1 of 6 (16.7%).
risk of death, 25.0% lower, RR 0.75, p = 1.00, treatment 3 of 20 (15.0%), control 1 of 5 (20.0%), NNT 20, day 30.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
PharmaMar et al., 2 Dec 2024, Randomized Controlled Trial, Belgium, preprint, 1 author, trial NCT05705167 (history) (NEREIDA). Contact: clinicaltrials@pharmamar.com.
$0 $500 $1,000+ Efficacy vs. cost for COVID-19 treatment protocols c19early.org December 2025 Belgium United Kingdom Russia USA Sudan Angola Colombia Kenya Mozambique Vietnam Peru Philippines China Uzbekistan Nepal Ethiopia Iran Ghana Mexico South Korea Germany Bangladesh Saudi Arabia Algeria Morocco Yemen Poland India DR Congo Madagascar Thailand Uganda Venezuela Nigeria Egypt Bolivia Taiwan Zambia Fiji Bosnia-Herzegovina Ukraine Côte d'Ivoire Bulgaria Greece Slovakia Singapore Iceland New Zealand Czechia Mongolia Israel Trinidad and Tobago Hong Kong North Macedonia Belarus Qatar Panama Serbia CAR Belgium favored high-profit treatments.The average efficacy of treatments was very low.High-cost protocols reduce early treatment, andforgo complementary/synergistic benefits. More effective More expensive 75% 50% 25% ≤0%
$0 $500 $1,000+ Efficacy vs. cost for COVID-19treatment protocols worldwide c19early.org December 2025 Belgium United Kingdom Russia USA Sudan Angola Colombia Kenya Mozambique Vietnam Peru Philippines China Uzbekistan Nepal Ethiopia Iran Ghana Mexico South Korea Germany Bangladesh Saudi Arabia Algeria Morocco Yemen Poland India DR Congo Madagascar Thailand Uganda Venezuela Nigeria Egypt Bolivia Zambia Fiji Bosnia-Herzegovina Ukraine Côte d'Ivoire Eritrea Bulgaria Greece Slovakia Singapore New Zealand Malawi Czechia Mongolia Israel Trinidad and Tobago North Macedonia Belarus Qatar Panama Serbia Syria Belgium favored high-profit treatments.The average efficacy was very low.High-cost protocols reduce early treatment,and forgo complementary/synergistic benefits. More effective More expensive 75% 50% 25% ≤0%
Late treatment
is less effective
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