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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
Sep 2021  
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Mortality -134% Improvement Relative Risk HCQ for COVID-19  Alotaibi et al.  LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 437 patients in Saudi Arabia Study compares with favipiravir, results vs. placebo may differ Higher mortality with HCQ (not stat. sig., p=0.051) Alotaibi et al., Int. J. General Medic.., Sep 2021 FavorsHCQ Favorsfavipiravir 0 0.5 1 1.5 2+
HCQ for COVID-19
1st treatment shown to reduce risk in March 2020
*, now with p < 0.00000000001 from 411 studies, recognized in 46 countries.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,300+ studies for 75 treatments.
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.
Study covers favipiravir and HCQ.
risk of death, 133.5% higher, RR 2.33, p = 0.05, treatment 193, control 244, multivariate.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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.
This PaperHCQAll
Effectiveness and Safety of Favipiravir Compared to Hydroxychloroquine for Management of Covid-19: A Retrospective Study
Musim Alotaibi, Ahmed Ali, Duaa Bakhshwin, Yasser Alatawi, Sultan Alotaibi, Abdullah Alhifany, Badr Alharthi, Nasser Alharthi, Awatef Alyazidi, Yasmeen Alharthi, Aziza Alrafiah
International Journal of General Medicine, doi:10.2147/ijgm.s329881
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 curves showed improved survival time and discharged time among patients in the HCQ versus FPV group with an insignificant difference between them (P = 0.85, P = 0.06, respectively). Conclusion: The present study concluded that FPV and HCQ showed comparable efficacy in decrease mortality and oxygen requirements. FPV likely has a more favorable safety profile regarding cardiac toxicity. A randomized clinical trial with large patient numbers is recommended to confirm the effectiveness of these drugs in COVID-19 patients.
Disclosure The authors declare no conflicts of interest in this work. International Journal of General Medicine Dovepress
Alotaibi, by TCPDF
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Late treatment
is less effective
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