Summary of COVID-19 dornase alfa studies
1. Åkesson et al., Aerosolized dornase alfa (DNase I) for the treatment of severe respiratory failure in COVID-19: a randomized controlled trial
76 patient dornase alfa late treatment RCT: 11% higher mortality (p=1) and 2% worse recovery (p=0.94).RCT 76 hospitalized COVID-19 patients showing no significant difference with inhaled dornase alfa (DNase I) for resolution of hypoxia or other clinical outcomes.
Apr 2025, Open Forum Infectious Diseases, https://academic.oup.com/ofid/advance-article/doi/10.1093/ofid/ofaf246/8119012, https://c19p.org/akesson
2. Files et al., Report of the first seven agents in the I-SPY COVID trial: a phase 2, open label, adaptive platform randomised controlled trial
127 patient dornase alfa late treatment RCT: 9% higher mortality (p=0.78) and 32% worse recovery (p=0.24).RCT severe COVID-19 patients showing no significant difference in outcomes with dornase alfa.
Mar 2023, eClinicalMedicine, https://www.sciencedirect.com/science/article/pii/S2589537023000664, https://c19p.org/filesdnase
3. Porter et al., Anti-inflammatory therapy with nebulized dornase alfa for severe COVID-19 pneumonia: a randomized unblinded trial
99 patient dornase alfa late treatment RCT: 130% higher mortality (p=1) and 10% higher hospital discharge (p=1).RCT 99 hospitalized COVID-19 patients showing significantly reduced C-reactive protein (CRP) levels and length of hospital stay with nebulized dornase alfa treatment in addition to standard of care (dexamethasone). Authors combine the randomized patients with retrospective patients using matching that does not match for COVID-19 severity. Dornase alfa was associated with a 33% reduction in CRP, a 63% higher chance of discharge at any timepoint up to 35 days, and increased lymphocyte counts. There was a trend towards reduced mortality which was not statistically significant.
Jul 2024, eLife, https://elifesciences.org/articles/87030, https://c19p.org/porter2