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Efficacy of Nitazoxanide in reducing the viral load in COVID-19 patients. Randomized, placebo-controlled, single-blinded, parallel group, pilot study

Silva et al., Medical Research Archives, doi:10.18103/mra.v11i2.3364 (date from preprint), NCT04463264
Mar 2021  
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Mean improvement in Ct 26% Improvement Relative Risk Viral load reduction < 35%.. 38% Nitazoxanide  Silva et al.  EARLY TREATMENT  RCT Is early treatment with nitazoxanide beneficial for COVID-19? RCT 36 patients in Argentina (July - December 2020) Improved viral clearance with nitazoxanide (not stat. sig., p=0.36) c19early.org Silva et al., Medical Research Archives, Mar 2021 Favorsnitazoxanide Favorscontrol 0 0.5 1 1.5 2+
Small RCT with 23 nitazoxanide and 13 control patients showing significantly more patients achieved over 35% reduction in viral load from baseline. NCT04463264 (history).
relative mean improvement in Ct, 26.5% better, RR 0.74, p = 0.36, treatment 23, control 13.
risk of viral load reduction < 35% at day 7, 38.3% lower, RR 0.62, p = 0.08, treatment 12 of 23 (52.2%), control 11 of 13 (84.6%), NNT 3.1.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Silva et al., 5 Mar 2021, Single Blind Randomized Controlled Trial, Argentina, peer-reviewed, 12 authors, study period July 2020 - December 2020, trial NCT04463264 (history).
This PaperNitazoxanideAll
Efficacy of Nitazoxanide in reducing the viral load in COVID-19 patients. Randomized, placebo-controlled, single-blinded, parallel group, pilot study.
Marcelo Silva, Andrés Espejo, María L Pereyra, Martín Lynch, Marcos Thompson, Hernán Taconelli, Patricia Baré, Matías J Pereson, Marcelo Garbini, Pablo Crucci, Diego Enriquez
doi:10.1101/2021.03.03.21252509
The fast spread of COVID-19 has overcrowded Public Health Systems facilities in major countries due to the large number of seriously ill patients, particularly those requiring admission to intensive care units. Reducing viral load, along with other recommended epidemiological measures, such as social distancing and home confinement, can in time significantly help to reduce the infection R0 (Basic Reproductive Rate) and then mitigate disease burden. Early negativization or otherwise reduction of the viral load can potentially diminish disease severity, resulting in a better-controlled public health response, avoiding collapse of healthcare systems. Nitazoxanide, a widely used thiazolide approved by the FDA as an antiparasitic drug, also approved in Brazil for Norovirus and Rotavirus treatments, has an excellent safety record for a variety of indications. Nitazoxanide exhibits activity in vitro against MERS-CoV and other coronaviruses; and a specific antiviral effect (in micro molar doses) against SARS-CoV-2. The objective of this study was to evaluate the efficacy and safety of Nitazoxanide in reducing the SARS-COV 2 viral load within 7 days of treatment in respiratory samples from COVID-19-infected patients with mild to moderate disease, compared to placebo. An interim analysis showed that the ratio of patients with a viral load reduction ≥ 35% from baseline up to day 7 of treatment was significantly greater for Nitazoxanide compared to placebo (47.8% vs.
References
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