An open-label, multicentre, randomised, adaptive platform trial of the safety and efficacy of several therapies, including antiviral therapies, versus control in mild/moderate cases of COVID-19

Strub-Wourgaft et al., ANTICOV, ANTICOV, Mar 2024
Progression -20% improvement lower risk ← → higher risk Hospitalization 12% Lopinavir/r..  ANTICOV  EARLY TREATMENT RCT Is early treatment with lopinavir/ritonavir beneficial for COVID-19? RCT 894 patients in multiple countries Trial compares with paracetamol, results vs. placebo may differ Trial underpowered to detect differences c19early.org Strub-Wourgaft et al., ANTICOV, March 2024 0 0.5 1 1.5 2+ RR
RCT 1,942 patients testing HCQ, lopinavir/ritonavir, nitazoxanide/ciclesonide, ivermectin/ASAQ, and fluoxetine/budesonide compared wirth paracetamol.
Paracetamol was used as a control group. Results with concurrent controls are only provided for nitazoxanide/ciclesonide. Other groups only have comparisons with the full control group. The full control group continues beyond the time of most arms, including patients at later times when COVID-19 risk was lower, therefore results may underestimate efficacy.
The nitazoxanide/ciclesonide concurrent controls are closer in time than the full group for ivermectin/ASAQ and fluoxetine/budesonide and may be a more appropriate comparison. The control group in this case shows worse results. We currently use the full control group results to be conservative.
Authors indicate that the data is available however it is not available as of May 2026.
This study is excluded in the after exclusion results of meta-analysis: significant confounding by time possible.
Study covers ivermectin, artemisinin, HCQ, budesonide, and lopinavir/ritonavir.
risk of progression, 19.7% higher, RR 1.20, p = 0.87, treatment 1 of 77 (1.3%), control 9 of 817 (1.1%), odds ratio converted to relative risk, SpO2 ≤93 or death, day 21, Table 14.2.2.1.
risk of hospitalization, 11.6% lower, RR 0.88, p = 1.00, treatment 1 of 77 (1.3%), control 12 of 817 (1.5%), NNT 588, COVID-19 hospitalization, day 21, Table 14.2.2.13.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Strub-Wourgaft et al., 28 Mar 2024, Randomized Controlled Trial, multiple countries, preprint, 12 authors, this trial compares with another treatment - results may be better when compared to placebo, ANTICOV trial.
Abstract: DNDi-01-COV (ANTICOV study) Abbreviated Clinical Study Report - Version 1.0 Date: 28 Mar 2024 Abbreviated Clinical Study Report An open-label, multicentre, randomised, adaptive platform trial of the safety and efficacy of several therapies, including antiviral therapies, versus control in mild/moderate cases of COVID-19 Short Title Name of product(s) Indication Phase Study Design Consortium Coordinator Consortium Coordinator’s Responsible Medical Officer Sponsors in each country with at least one participant screened Study Initiation Study completion Study Report Date ANTICOV Hydroxychloroquine sulphate; lopinavir/ritonavir ; nitazoxanide/ciclesonide; ivermectin/artesunateamodiaquine; fluoxetine/budesonide; paracetamol Mild/moderate infection in outpatients with Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) Phase III Multicentre, multiple-country, randomised, open-label, adaptive, platform clinical study in adult patients with confirmed coronavirus disease 2019 (COVID-19) diagnosis and presenting with viral syndrome DNDi, 15 chemin Camille-Vidart, 1202 Geneva, Switzerland (until 01 March 2021: 15 chemin Louis-Dunant, 1202 Geneva, Switzerland) Phone: +41 22 906 9230 Dr Nathalie Strub-Wourgaft Burkina Faso, Guinea: Inserm/ANRS (France) Democratic Republic of the Congo, Kenya, and Sudan: DNDi (Switzerland) Ethiopia: Institute of Tropical Medicine (Belgium) Ghana: Bernhard-Nocht-Institut für Tropenmedizin (Germany) Ivory Coast: Centre Suisse de Recherches Scientifiques (Ivory Coast) Mali: Centre for Vaccine Development (Mali) Mozambique: ISGlobal (Spain) Tanzania: Ifakara Health Institute (Tanzania) Brazil: Cardresearch (Sponsor of Together Trial, Brazil) Date 21 September 2020 21 December 2022 28 March 2024 This study was performed in compliance with Good Clinical Practices (GCP), including the archiving of essential documents CSR Template_Version 1.0_ 11 Apr 2008 – Updated 26 Aug 2020 Page 1 of 1569 1570 DNDi-01-COV (ANTICOV study) Abbreviated Clinical Study Report - Version 1.0 Date: 28 Mar 2024 2. SYNOPSIS Name of Coordinating Sponsor: Drugs for Neglected Diseases initiative (DNDi) Name of Active Ingredients: Hydroxychloroquine sulphate; lopinavir/ritonavir; nitazoxanide/ciclesonide; ivermectin/artesunate-amodiaquine; fluoxetine/budesonide; paracetamol (control) Name of Finished Products: Marketed formulations of the investigational products Title of Study: An open-label, multicentre, randomised, adaptive platform trial of the safety and efficacy of several therapies, including antiviral therapies, versus control in mild/moderate cases of COVID-19 Investigators: 12 Coordinating Principal Investigators in 12 countries Study Centre(s): 26 sites (with screened patients) in 12 countries: 11 African countries (Burkina Faso, Democratic Republic of the Congo [DRC], Ethiopia, Ghana, Guinea, Ivory Coast, Kenya, Mali, Mozambique, Sudan, and Tanzania) + Brazil Publication (Reference): None Studied Period (years): First Patient First Visit: 21 Sep 2020 Last Patient Last Visit: 21 Dec 2022 Phase of Development: Phase III Objectives: The overall objective was to determine the efficacy and safety of various treatment regimens in outpatients with mild/moderate coronavirus disease 2019 (COVID-19) to prevent the need for hospitalisation for specialised care due to severe progression of the disease. Primary Objective: • To compare the efficacy of alternative treatment strategies versus (vs) control on the risk of progression..
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