0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ XPORT-CoV-1001 Geils (SB RCT) -286% 3.86 [0.89-16.9] death 10/66 2/51 Improvement, RR [CI] Treatment Control Tau​2​ = 0.00, I​2​ = 0.0%, p = 0.072 Late treatment -286% 3.86 [0.89-16.9] 10/66 2/51 286% higher risk All studies -286% 3.86 [0.89-16.9] 10/66 2/51 286% higher risk 1 selinexor COVID-19 study c19early.org November 2025 Tau​2​ = 0.00, I​2​ = 0.0%, p = 0.072 Effect extraction pre-specified(most serious outcome) Favors selinexor Favors control
Selinexor is an oral small molecule Selective Inhibitor of Nuclear Export (SINE) that blocks the transport protein exportin-1 (XPO1). By inhibiting XPO1, selinexor prevents the nuclear export of viral ribonucleoproteins and restores the nuclear localization of host anti-inflammatory and tumor suppressor proteins, theoretically reducing viral replication and mitigating cytokine storm. Recent:
Geils.
Oct 10
2020
 Geils et al., Karyopharm Therapeutics Treatment of Severe COVID-19 with Low-Dose Selinexor: Demonstration of Anti-Viral and Anti-Inflammatory Activities in a Randomized, International, Multicenter, Placebo-Controlled Phase 2 Clinical Trial
286% higher mortality (p=0.07), 39% higher ventilation (p=0.58), 11% higher ICU admission (p=0.71), and 16% lower hospital discharge (p=0.68). RCT 188 hospitalized patients with severe COVID-19 showing higher mortality (p=0.07) and no significant clinical improvement with oral selinexor (20mg) compared to placebo. In the intention-to-treat analysis, the study failed its primary ..