Effectiveness and Safety of Favipiravir Compared to Hydroxychloroquine for Management of Covid-19: A Retrospective Study
Alotaibi et al., International Journal of General Medicine, 2021:14
Alotaibi et al., Effectiveness and Safety of Favipiravir Compared to Hydroxychloroquine for Management of Covid-19: A.., International Journal of General Medicine, 2021:14
Retrospective hospitalized patients in Saudi Arabia, showing lower mortality with favipiravir compared to HCQ, not quite reaching statistical significance. Authors do not indicate the factors behind which therapy was chosen. May be subject to significant confounding by indication and confounding by time.
Alotaibi et al., 14 Sep 2021, retrospective, Saudi Arabia, peer-reviewed, 11 authors, this trial compares with another treatment - results may be better when compared to placebo.
Abstract: International Journal of General Medicine
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ORIGINAL RESEARCH
Effectiveness and Safety of Favipiravir Compared
to Hydroxychloroquine for Management of
Covid-19: A Retrospective Study
Musim Alotaibi 1,2
Ahmed Ali 1,3
Duaa Bakhshwin 4
Yasser Alatawi 5
Sultan Alotaibi 6
Abdullah Alhifany
Badr Alharthi 2
Nasser Alharthi 2
Awatef Alyazidi 2
Yasmeen Alharthi 2
Aziza Alrafiah 8
7
1
Department of Pharmacology, King
Abdulaziz University, Jeddah City,
Kingdom of Saudi Arabia; 2Department of
Pharmacy, King Faisal Medical Complex,
Taif City, Kingdom of Saudi Arabia;
3
Department of Pharmaceutics, Assiut
University, Assiut City, Egypt;
4
Department of Pharmacotherapy and
Outcomes Science, King Abdulaziz
University, Jeddah City, Kingdom of Saudi
Arabia; 5Department of Pharmacy
Practice, University of Tabuk, Tabuk City,
Kingdom of Saudi Arabia; 6Department of
Pharmacy, King Abdul-Aziz Medical,
Jeddah City, Kingdom of Saudi Arabia;
7
Department of Clinical Pharmacy
College of Pharmacy, Umm Al-Qura
University, Makkah, Kingdom of Saudi
Arabia; 8Department of Medical
Laboratory Technology, King Abdulaziz
University, Jeddah City, Kingdom of Saudi
Arabia
Correspondence: Aziza Alrafiah
P.O Box 80200, Jeddah, 21589, Kingdom
of Saudi Arabia
Tel +966 126401000 Ext. 23495
Fax +966 126401000 Ext. 21686
Email aalrafiah@kau.edu.sa
Background: Coronavirus disease (COVID-19) is an infectious disease due to SARS-COV
-2. Patients with risk factors are vulnerable to severe morbidity and mortality. Favipiravir
(FPV) and hydroxychloroquine (HCQ) are considered possible COVID-19 treatments.
Objective: To investigate the effectiveness and safety of FPV compared to HCQ in patients
with COVID-19 as the standard of care approved by the national protocol there.
Methods: This is a retrospective cohort study on patients with COVID-19 who were
administered either FPV or HCQ at King Faisal Medical Complex, Taif, Saudi Arabia,
from June 2020 to August 2020.
Results: In total, 508 patients were included in the analysis. Patients were categorized into three
groups by medication. Patients enrolled in this study were 244 (55.8%) on FPV, 193 (44.2%) on
HCQ and 71 (13.81%) on neither medication. Patients who received FPV had higher age and
greater comorbidity. Most of the patients were discharged on day 14 (n = 303, 59.6%), 26 (36.6%)
in neither med, 154 (63.1%) in FPV and 123 (63.7%) in HCQ groups with significant difference
between groups (P < 0.0001). Mortality rate was 8.2% (n = 20) in FPV and 7.3% (n = 14) in HCQ
groups with significant difference between groups (P = 0.048). Regarding drug safety, 19.7% of
patients treated with FPV vs 7.8% HCQ have adverse effects with significant difference between
groups (P < 0.0001). Most of the side effects were increase ALT and AST. Meanwhile, prolonged
Q-T interval was reported only in the HCQ group (2.6%). From Cox regression modeling, only
mechanical ventilation due to Covid 19 was predictive for mortality (HR: 16.598, 95% CI: 7.095–
38.828, P < 0.0001). Meanwhile, there was no significant difference in the prediction of discharge
of FPV (vs HCQ) (HR: 0.933, 95% CI: 0.729–1.195, P = 0.5843), predictors of mortality were
HCQ (vs FPV) (HR: 2.3, 95% CI: 0.994–5.487, P = 0.0518). Kaplan–Meier survival..
Late treatment is less effective
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