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All Studies   Meta Analysis       

A Phase 2 Trial of the Effect of Antiandrogen Therapy on COVID-19 Outcome: No Evidence of Benefit, Supported by Epidemiology and In Vitro Data

Welén et al., European Urology, doi:10.1016/j.eururo.2021.12.013, NCT04475601
Dec 2021  
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Mortality 2% Improvement Relative Risk Mortality (b) 11% Mortality (c) -151% ICU admission -28% ICU admission (b) 13% ICU admission (c) 21% Hospitalization -23% Hospitalization (b) -24% Hospitalization (c) -40% Antiandrogens for COVID-19  Welén et al.  Prophylaxis Is prophylaxis with antiandrogens beneficial for COVID-19? Retrospective 5,338 patients in Sweden Higher ICU admission (p=0.28) and hospitalization (p=0.094), not sig. c19early.org Welén et al., European Urology, December 2021 Favorsvarious Favorscontrol 0 0.5 1 1.5 2+
7th treatment shown to reduce risk in September 2020, now with p = 0.000000056 from 49 studies.
No treatment is 100% effective. Protocols combine treatments.
5,100+ studies for 111 treatments. c19early.org
Retrospective 7,894 COVID+ prostate cancer patients, analyzing patients on antiandrogen treatment, ADT, and ADT + abiraterone acetate or enzalutamide, showing mixed results and higher mortality for ADT + abiraterone acetate or enzalutamide.
This paper also includes a small RCT which is listed separately, and an In Vitro HBEC study showing no significant differences (p = 0.084). The supplementary data is not currently available. NCT04475601 (history).
For discussion of issues with this study see1-4.
risk of death, 2.0% lower, HR 0.98, p = 0.94, treatment 21 of 358 (5.9%), control 167 of 4,980 (3.4%), adjusted per study, antiandrogen treatment.
risk of death, 11.0% lower, HR 0.89, p = 0.66, treatment 20 of 334 (6.0%), control 167 of 4,980 (3.4%), adjusted per study, ADT.
risk of death, 151.0% higher, HR 2.51, p < 0.001, treatment 24 of 152 (15.8%), control 167 of 4,980 (3.4%), adjusted per study, ADT and abiraterone acetate or enzalutamide.
risk of ICU admission, 28.0% higher, HR 1.28, p = 0.28, treatment 24 of 358 (6.7%), control 216 of 4,980 (4.3%), adjusted per study, antiandrogen treatment.
risk of ICU admission, 13.0% lower, HR 0.87, p = 0.62, treatment 16 of 334 (4.8%), control 216 of 4,980 (4.3%), adjusted per study, ADT.
risk of ICU admission, 21.0% lower, HR 0.79, p = 0.60, treatment 6 of 152 (3.9%), control 216 of 4,980 (4.3%), adjusted per study, ADT and abiraterone acetate or enzalutamide.
risk of hospitalization, 23.0% higher, HR 1.23, p = 0.09, treatment 126 of 358 (35.2%), control 1,108 of 4,980 (22.2%), adjusted per study, antiandrogen treatment.
risk of hospitalization, 24.0% higher, HR 1.24, p = 0.09, treatment 126 of 334 (37.7%), control 1,108 of 4,980 (22.2%), adjusted per study, ADT.
risk of hospitalization, 40.0% higher, HR 1.40, p = 0.06, treatment 66 of 152 (43.4%), control 1,108 of 4,980 (22.2%), adjusted per study, ADT and abiraterone acetate or enzalutamide.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Welén et al., 14 Dec 2021, retrospective, Sweden, peer-reviewed, 27 authors, trial NCT04475601 (history). Contact: andreas.josefsson@umu.se.
This PaperAntiandrogensAll
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J Urol. In press. ' 'https://doi.org/10.1097/ju.0000000000002180.', 'DOI': '10.1097/JU.0000000000002180'}, { 'key': '10.1016/j.eururo.2021.12.013_b0085', 'article-title': 'Proxalutamide significantly accelerates viral clearance and reduces ' 'time to clinical remission in patients with mild to moderate COVID-19: ' 'results from a randomized, double-blinded, placebo-controlled trial', 'volume': '13', 'author': 'Cadegiani', 'year': '2021', 'journal-title': 'Cureus'}, { 'key': '10.1016/j.eururo.2021.12.013_b0090', 'article-title': 'Targeting transcriptional regulation of SARS-CoV-2 entry factors ACE2 ' 'and TMPRSS2', 'volume': '118', 'author': 'Qiao', 'year': '2020', 'journal-title': 'Proc Natl Acad Sci U S A'}, { 'key': '10.1016/j.eururo.2021.12.013_b0095', 'doi-asserted-by': 'crossref', 'first-page': '866', 'DOI': '10.1038/s41467-021-21171-x', 'article-title': 'Distinct mechanisms for TMPRSS2 expression explain organ-specific ' 'inhibition of SARS-CoV-2 infection by enzalutamide', 'volume': '12', 'author': 'Li', 'year': '2021', 'journal-title': 'Nat Commun'}, { 'key': '10.1016/j.eururo.2021.12.013_b0100', 'doi-asserted-by': 'crossref', 'DOI': '10.3389/fmed.2021.668698', 'article-title': 'Proxalutamide reduces the rate of hospitalization for COVID-19 male ' 'outpatients: a randomized double-blinded placebo-controlled trial', 'volume': '8', 'author': 'McCoy', 'year': '2021', 'journal-title': 'Front Med'}, { 'key': '10.1016/j.eururo.2021.12.013_b0105', 'doi-asserted-by': 'crossref', 'first-page': '437', 'DOI': '10.1038/s41586-020-2355-0', 'article-title': 'Viral and host factors related to the clinical outcome of COVID-19', 'volume': '583', 'author': 'Zhang', 'year': '2020', 'journal-title': 'Nature'}, { 'key': '10.1016/j.eururo.2021.12.013_b0110', 'unstructured': 'Karimi A, Nowroozi A, Alilou S, Amini E. Effects of androgen deprivation ' 'therapy on COVID-19 in patients with prostate cancer: a systematic ' 'review and meta-analysis. Urol J. In press. 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