Favipiravir in the Treatment of Outpatient COVID-19: A Multicenter, Randomized, Triple-Blind, Placebo-Controlled Clinical Trial
Atefeh Vaezi, Mehrzad Salmasi, Forogh Soltaninejad, Mehrdad Salahi, Shaghayegh Haghjooy Javanmard, Babak Amra
Advances in Respiratory Medicine, doi:10.3390/arm91010004
What are the main findings?
• Favipiravir, an RNA-dependent RNA polymerase inhibitor, shows no benefit in preventing the hospitalization of mild to moderate COVID-19 patients. What is the implication of the main finding?
• Our results may inform decisions on the exclusion of Favipiravir from mild to moderate COVID-19 treatment guidelines.
Informed Consent Statement: Patients were informed about the study protocol and objectives and were asked to sign an informed consent before participation. All data were managed, analyzed, and reported anonymously. Medications were provided by the research team and imposed no costs on patients.
Conflicts of Interest: The authors declare that they have no conflict of interest.
References
Alqahtani, Kumar, Aljawder, Abdulrahman, Mohamed et al., Randomized controlled trial of favipiravir, hydroxychloroquine, and standard care in patients with mild/moderate COVID-19 disease, Sci. Rep,
doi:10.1038/s41598-022-08794-w
Baranovich, Wong, Armstrong, Marjuki, Webby et al., T-705 (Favipiravir) Induces Lethal Mutagenesis in Influenza A H1N1 Viruses In Vitro, J. Virol,
doi:10.1128/JVI.02346-12
Bosaeed, Alharbi, Mahmoud, Alrehily, Bahlaq et al., Efficacy of favipiravir in adults with mild COVID-19: A randomized, double-blind, multicentre, placebocontrolled clinical trial, Clin. Microbiol. Infect,
doi:10.1016/j.cmi.2021.12.026
Bryant, Lawrie, Fordham, Ivermectin for Prevention and Treatment of COVID-19 Infection: A Systematic Review, Meta-analysis, and Trial Sequential Analysis to Inform Clinical Guidelines, Am. J. Ther,
doi:10.1097/MJT.0000000000001402
Cai, Yang, Liu, Chen, Shu et al., Experimental Treatment with Favipiravir for COVID-19: An Open-Label Control Study, Engineering,
doi:10.1016/j.eng.2020.03.007
Darab, Keshavarz, Sadeghi, Shahmohamadi, Kavosi, The economic burden of coronavirus disease 2019 (COVID-19): Evidence from Iran, BMC Health Serv. Res
Deng, Yang, Yang, Chen, Qiu et al., Evaluation of favipiravir in the treatment of COVID-19 based on the real-world, Expert Rev. Anti-Infect. Ther,
doi:10.1080/14787210.2022.2012155
Dessie, Zewotir, Mortality-related risk factors of COVID-19: A systematic review and meta-analysis of 42 studies and 423,117 patients, BMC Infect. Dis,
doi:10.1186/s12879-021-06536-3
Frediansyah, Nainu, Dhama, Mudatsir, Harapan, Remdesivir and its antiviral activity against COVID-19: A systematic review, Clin. Epidemiology Glob. Health,
doi:10.1016/j.cegh.2020.07.011
Gonçalves, Bertrand, Ke, Comets, De Lamballerie et al., Timing of antiviral treatment initiation is critical to reduce SARS-CoV-2 viral load. CPT Pharmacomet, Syst. Pharmacol,
doi:10.1002/psp4.12543
Goyal, Cardozo-Ojeda, Schiffer, Potency and timing of antiviral therapy as determinants of duration of SARS-CoV-2 shedding and intensity of inflammatory response, Sci. Adv,
doi:10.1126/sciadv.abc7112
Hassaniazad, Farshidi, Gharibzadeh, Bazram, Khalili et al., Efficacy and safety of favipiravir plus interferon-beta versus lopinavir/ritonavir plus interferon-beta in moderately ill patients with COVID-19: A randomized clinical trial, J. Med. Virol,
doi:10.1002/jmv.27724
Hassanipour, Arab-Zozani, Amani, Heidarzad, Fathalipour et al., Addendum: The efficacy and safety of Favipiravir in treatment of COVID-19: A systematic review and meta-analysis of clinical trials, Sci. Rep
Ivashchenko, Dmitriev, Vostokova, Azarova, Blinow et al., AVIFAVIR for Treatment of Patients With Moderate Coronavirus Disease 2019 (COVID-19): Interim Results of a Phase II/III Multicenter Randomized Clinical Trial, Clin. Infect. Dis
Khamis, Al Naabi, Al Lawati, Ambusaidi, Al Sharji et al., Randomized controlled open label trial on the use of favipiravir combined with inhaled interferon beta-1b in hospitalized patients with moderate to severe COVID-19 pneumonia, Int. J. Infect. Dis,
doi:10.1016/j.ijid.2020.11.008
Pan, Peto, Henao-Restrepo, Preziosi, Sathiyamoorthy et al., Repurposed Antiviral Drugs for COVID-19-Interim WHO Solidarity Trial Results, N. Engl. J. Med
Reddy, Patil, Khobragade, Balki, Raj et al., Evaluation of the Safety and Efficacy of Favipiravir in Adult Indian Patients with Mild-to-Moderate COVID-19 in a Real-World Setting, Int. J. Gen. Med,
doi:10.2147/IJGM.S349241
Schulz, Altman, Moher, Consort, statement: Updated guidelines for reporting parallel group randomised trials, J. Pharmacol. Pharmacother,
doi:10.4103/0976-500X.72352
Shrestha, Budhathoki, Khadka, Shah, Pokharel et al., Favipiravir versus other antiviral or standard of care for COVID-19 treatment: A rapid systematic review and meta-analysis, Virol. J,
doi:10.1186/s12985-020-01412-z
Sirijatuphat, Manosuthi, Niyomnaitham, Owen, Copeland et al., Early treatment of Favipiravir in COVID-19 patients without pneumonia: A multicentre, open-labelled, randomized control study, Emerg. Microbes Infect,
doi:10.1080/22221751.2022.2117092
Solaymani-Dodaran, Ghanei, Bagheri, Qazvini, Vahedi et al., Safety and efficacy of Favipiravir in moderate to severe SARS-CoV-2 pneumonia, Int. Immunopharmacol,
doi:10.1016/j.intimp.2021.107522
Soy, Keser, Atagündüz, Tabak, Atagündüz et al., Cytokine storm in COVID-19: Pathogenesis and overview of anti-inflammatory agents used in treatment, Clin. Rheumatol,
doi:10.1007/s10067-020-05190-5
Worldometer, COVID-19 Pandemic