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Budesonide for COVID-19
12 studies from 191 scientists
27,682 patients in 10 countries
Statistically significant lower risk for mortality, progression, and recovery.
49%, 28% lower risk for early and late treatment CI -617-96%, 1-47%
33% lower risk in 5 RCTs CI -38-67%
COVID-19 Budesonide studies. Sep 2023.
0 0.5 1 1.5+ All studies 30% With exclusions 32% Mortality 27% Hospitalization 44% Recovery 29% Cases 33% RCTs 33% RCT mortality 11% Prophylaxis 28% Early 49% Late 28% Favorsbudesonide Favorscontrol
Budesonide has been officially adopted in all or part of 8 countries (9 including non-government medical organizations). Submit updates/corrections.
Sep 24
Covid Analysis Budesonide for COVID-19: real-time meta analysis of 12 studies
Statistically significant lower risk is seen for mortality, progression, and recovery. 8 studies from 8 independent teams in 7 countries show statistically significant improvements. • Meta analysis using the most serious outcome reporte..
Aug 31
Hautefort et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2023.08.022 Local budesonide therapy in the management of persistent hyposmia in suspected non-severe COVID-19 patients: Results of a randomized controlled trial
RCT 123 post-COVID-19 hyposmia patients, showing no significant difference in smell recovery with budesonide. 2 patients experienced improvement of more than two points on the ODORATEST score compared with 0 in the control group.
Aug 1
Marcy et al., NCT04920838 Early Treatment of Vulnerable Individuals With Non-Severe SARS-CoV-2 Infection: A Multi-Arm Multi-Stage Randomized Trial (MAMS) to Evaluate the Effectiveness of Several Specific Treatments in Reducing the Risk of Clinical Worsening or Death in Sub-Saharan Africa (COVERAGE-Africa)
Estimated 600 patient budesonide early treatment RCT with results expected soon (estimated completion over 1 month ago).
Apr 17
Reis et al., Annals of Internal Medicine, doi:10.7326/M22-3305 Oral Fluvoxamine With Inhaled Budesonide for Treatment of Early-Onset COVID-19
12% lower hospitalization (p=1) and 50% lower progression (p=0.04). Low-risk (1% hospitalization) outpatient RCT with 738 fluvoxamine + budesonide patients and 738 placebo patients, showing significantly lower hospitalization/ER visits with treatment. Other arms of this trial show many critical issues [Re..
Mar 3
Samajdar et al., Lung India, doi:10.4103/lungindia.lungindia_268_22 Effectiveness of budesonide formoterol fixed-dose combination MDI in reducing cough symptoms in COVID-19 patients: A real-world evidence study
69% lower hospitalization (p=0.07) and 29% improved recovery (p=0.008). Prospective study of 102 patients in India, showing improved recovery of cough with budesonide+formoterol. Authors note better results with earlier treatment. Budesonide 800mcg + formoterol 12mcg bid for 7 days.
Nov 1
Korea United Pharm., NCT05055414 A Multi-center, Randomized, Double-blind, Placebo-controlled, Parallel, Phase 2 Study to Evaluate the Efficacy and Safety of UI030 in COVID-19 Patients
Estimated 140 patient budesonide early treatment RCT with results not reported over 10 months after estimated completion.
Aug 31
Yang et al., Open Medicine, doi:10.1515/med-2022-0569 The relationship between oxygen therapy, drug therapy, and COVID-19 mortality
11% higher mortality (p=0.85). Retrospective 185 hospitalized COVID-19 patients in China, showing no significant difference in mortality with budesonide use in unadjusted results.
Aug 16
Loucera et al., medRxiv, doi:10.1101/2022.08.14.22278751 Real-world evidence with a retrospective cohort of 15,968 Andalusian COVID-19 hospitalized patients suggests 21 new effective treatments and one drug that increases death risk
22% lower mortality (p=0.004). Retrospective 15,968 COVID-19 hospitalized patients in Spain, showing lower mortality with existing use of several medications including metformin, HCQ, aspirin, vitamin D, vitamin C, and budesonide.
Apr 18
Gavriilidis et al., Clinical Immunology, doi:10.1016/j.clim.2022.109016 Combined administration of inhaled DNase, baricitinib and tocilizumab as rescue treatment in COVID-19 patients with severe respiratory failure
74% lower mortality (p=0.05), 76% lower ventilation (p=0.02), and 20% shorter hospitalization (p=0.02). Small retrospective study of hospitalized patients with severe respiratory failure, 22 treated with a combination of budesonide, tocilizumab, baricitinib, dornase alfa, and salbutamol or/and ipratropium, and 26 SOC patients, showing lower..
Mar 16
Duvignaud et al., Clinical Microbiology and Infection, doi:10.1016/j.cmi.2022.02.031 Inhaled ciclesonide for outpatient treatment of COVID-19 in adults at risk of adverse outcomes: a randomised controlled trial (COVERAGE)
80% lower mortality (p=0.24), 36% higher hospitalization (p=0.52), and 20% higher progression (p=0.69). Early terminated RCT with 110 ciclesonide patients and 107 patients treated with vitamins A, B1, B2, B3, B5, B6, B8, B9, B12, C, D3, and E, calcium, chromium, copper, iron, manganese, molybdenum, selenium, and zinc (Azinc Vitality), show..
Feb 10
Agustí et al., European Respiratory Journal, doi:10.1183/13993003.03036-2021 Add-on inhaled budesonide in the treatment of hospitalised patients with COVID-19: a randomised clinical trial
23% higher mortality (p=1) and 39% lower progression (p=0.69). Small early-terminated RCT with 40 inhaled budesonide and 49 control patients, showing no significant differences. 400µg/12h via Pulmicort Turbuhaler.
Jan 8
Monserrat Villatoro et al., Pharmaceuticals, doi:10.3390/ph15010078 A Case-Control of Patients with COVID-19 to Explore the Association of Previous Hospitalisation Use of Medication on the Mortality of COVID-19 Disease: A Propensity Score Matching Analysis
49% lower mortality (p=0.01). PSM retrospective 3,712 hospitalized patients in Spain, showing lower mortality with existing use of azithromycin, bemiparine, budesonide-formoterol fumarate, cefuroxime, colchicine, enoxaparin, ipratropium bromide, loratadine, mepyramine..
Dec 31
Alsultan et al., Interdisciplinary Perspectives on Infectious Diseases, doi:10.1155/2021/2129006 Efficacy of Colchicine and Budesonide in Improvement Outcomes of Patients with Coronavirus Infection 2019 in Damascus, Syria: A Randomized Control Trial
7% higher mortality (p=1) and 20% shorter hospitalization. Small RCT 49 severe condition hospitalized patients in Syria, showing lower mortality with colchicine and shorter hospitalization time with both colchicine and budesonide (all of these are not statistically significant).
Nov 22
Clemency et al., JAMA Internal Medicine, doi:10.1001/jamainternmed.2021.6759 Efficacy of Inhaled Ciclesonide for Outpatient Treatment of Adolescents and Adults With Symptomatic COVID-19
54% lower hospitalization (p=0.26), 81% fewer combined hospitalization/ER visits (p=0.03), and 15% improved recovery (p=0.25). RCT 400 outpatients in the USA, showing significantly lower ER visits/hospital admission with ciclesonide treatment. NCT04377711. Publication was delayed about a year after completion and the primary endpoint was changed about 4 months af..
Nov 10
Al Sulaiman et al., Journal of Intensive Care Medicine, doi:10.1177/08850666211053548 The Role of Inhaled Corticosteroids (ICS) in Critically Ill Patients With COVID-19: A Multicenter, Cohort Study
32% lower mortality (p=0.13). Combined retrospective (Mar-Jun 2020) and prospective (until Mar 2021) study of 954 COVID+ ICU patients in Saudi Arabia, 68 treated with ICS (80% budesonide or budesonide/formoterol, 20% fluticasone/salmeterol), showing lower mortality wi..
Oct 27
Baker et al., medRxiv, doi:10.1101/2021.10.26.21265512 Dampening of the respiratory cytokine storm is promoted by inhaled budesonide in patients with early COVID-19
Analysis of inflammatory mediators in the nasal mucosa of patients in the STOIC1 trial and a cohort of SARS-CoV-2 negative controls, showing that budesonide treatment decreased IL-33 and IFN-γ, implying a reduction in epithelial damage an..
Sep 9
Lee et al., Research Square, doi:10.21203/ Association Between Inhaled Corticosteroid Use and the Severe Acute Respiratory Syndrome Coronavirus 2 Infection: A Nationwide Population-based Study in South Korea
33% fewer cases (p=0.1). Retrospective 44,968 patients in South Korea, 7,019 on inhaled corticosteroids, showing no statistically significant differences in COVID-19 cases.
Aug 23
Strauss et al., The Journal of Allergy and Clinical Immunology: In Practice, doi:10.1016/j.jaip.2021.08.007 Intranasal Corticosteroids Are Associated with Better Outcomes in Coronavirus Disease 2019
24% lower mortality (p=0.01), 22% lower ICU admission (p=0.003), and 19% lower hospitalization (p<0.0001). Retrospective 72,147 COVID-19+ patients in the USA, showing lower mortality, ICU admission, and hospitalization with intranasal corticosteroid use.
Jul 20
Heinen et al., Viruses, doi:10.3390/v13071411 Antiviral Effect of Budesonide against SARS-CoV-2
In Vitro study showing dose-dependent inhibition of SARS-CoV-2 with budesonide.
May 28
Taille et al., NCT04331054 Protective Role of Inhaled Steroids for Covid-19 Infection
146 patient budesonide late treatment RCT with results not reported over 2 years after completion.
May 5
Konduri et al., bioRxiv, doi:10.1101/2021.05.05.442779 ProLung™-budesonide Inhibits SARS-CoV-2 Replication and Reduces Lung Inflammation
In Vitro study and animal study showing that ProLung™-budesonide inhibits SARS-CoV-2 replication (results for budesonide were not provided). ProLung™-budesonide and budesonide significantly decreased lung inflammation. ProLung™-budesonide..
Apr 12
Yu et al., The Lancet, doi:10.1016/S0140-6736(21)01744-X (date from preprint) Inhaled budesonide for COVID-19 in people at higher risk of adverse outcomes in the community: interim analyses from the PRINCIPLE trial
39% lower mortality (p=0.45), 6% lower ventilation (p=1), 52% lower ICU admission (p=0.07), and 25% lower combined mortality/hospitalization (p=0.96). Interim results from the PRINCIPLE trial, 1,073 treated with budesonide starting a median of 6 days after symptom onset, showing lower hospitalization/death, and faster recovery with treatment.
Mar 30
Holt et al., Thorax, doi:10.1136/thoraxjnl-2021-217487 Risk factors for developing COVID-19: a population-based longitudinal study (COVIDENCE UK)
32% fewer cases (p=0.03). Prospective survey-based study with 15,227 people in the UK, showing lower risk of COVID-19 cases with vitamin A, vitamin D, zinc, selenium, probiotics, and inhaled corticosteroids; and higher risk with metformin and vitamin C. Statistica..
Feb 8
Ramakrishnan et al., Lancet Respiratory Medicine, doi:10.1016/S2213-2600(21)00160-0 (date from preprint) Inhaled budesonide in the treatment of early COVID-19 (STOIC): a phase 2, open-label, randomised controlled trial
82% fewer combined hospitalization/ER visits (p=0.02) and 67% improved recovery (p=0.003). RCT with 73 budesonide patients and 73 control patients, showing significantly lower combined risk of an ER visit or hospitalization, and lower risk of no recovery at day 14.
Oct 18
Ramlall et al., medRxiv, doi:10.1101/2020.10.15.20213546 Melatonin is significantly associated with survival of intubated COVID-19 patients
71% lower mortality (p=0.01). Retrospective 948 intubated patients, 33 treated with budesonide, showing lower mortality with treatment.
May 20
Afazeli et al., NCT04331470 Evaluation of Efficacy of Pharmacotherapy Treatment of COVID- 19 Infection Using Oral Levamisole and Formoterol+Budesonide Inhaler and Comparison of This Treatment Protocol With Standard National Treatment of the Disease
Estimated 30 patient budesonide early treatment RCT with results not reported over 3 years after estimated completion.
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