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0 0.5 1 1.5 2+ Mortality 48% Improvement Relative Risk c19hcq.org Panda et al. CTRI/2020/06/025575 HCQ RCT LATE TREATMENT Is late treatment with HCQ+ribavirin beneficial for COVID-19? RCT 41 patients in India (June 2020 - May 2021) Lower mortality with HCQ+ribavirin (not stat. sig., p=0.45) Panda et al., Clinical Pharmacology: Advances an.., doi:10.2147/CPAA.S325083 Favors HCQ Favors control

Antiviral Combination Clinically Better Than Standard Therapy in Severe but Not in Non-Severe COVID-19

Panda et al., Clinical Pharmacology: Advances and Applications, doi:10.2147/CPAA.S325083, CTRI/2020/06/025575
Panda et al., Antiviral Combination Clinically Better Than Standard Therapy in Severe but Not in Non-Severe COVID-19, Clinical Pharmacology: Advances and Applications, doi:10.2147/CPAA.S325083, CTRI/2020/06/025575
Sep 2021   Source   PDF  
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RCT 111 patients in India in 5 groups: severe patients: A) standard treatment, B) hydroxychloroquine+ribavirin+standard treatment, or C) lopinavir+ritonavir+ribavirin+standard treatment, and non-severe: A) standard treatment or B) hydroxychloroquine+ribavirin. Non-severe patients were transferred to the severe group on progression.
risk of death, 47.5% lower, RR 0.53, p = 0.45, treatment 3 of 20 (15.0%), control 6 of 21 (28.6%), NNT 7.4.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Panda et al., 30 Sep 2021, Randomized Controlled Trial, India, peer-reviewed, 13 authors, study period June 2020 - May 2021, this trial uses multiple treatments in the treatment arm (combined with ribavirin) - results of individual treatments may vary, trial CTRI/2020/06/025575.
Contact: motherprasanna@rediffmail.com.
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Abstract: Clinical Pharmacology: Advances and Applications Dovepress open access to scientific and medical research Clinical Pharmacology: Advances and Applications For personal use only. Open Access Full Text Article ORIGINAL RESEARCH Antiviral Combination Clinically Better Than Standard Therapy in Severe but Not in Non-Severe COVID-19 Prasan Kumar Panda 1 Budha O Singh 1 Bikram Moirangthem 1 Yogesh Arvind Bahurupi 2 Sarama Saha 3 Girraj Saini 4 Minakshi Dhar 1 Mukesh Bairwa 1 Venkatesh Srinivasa Pai 1 Ankit Agarwal 5 Girish Sindhwani 6 Shailendra Handu 7 Ravi Kant 8 1 Department of Medicine (Infectious Disease Division), All India Institute of Medical Sciences (AIIMS), Rishikesh, India; 2Department of Community and Family Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, India; 3Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Rishikesh, India; 4Department of Nursing, All India Institute of Medical Sciences (AIIMS), Rishikesh, India; 5 Department of Critical Care Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, India; 6Department of Pulmonary Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, India; 7Department of Pharmacology, All India Institute of Medical Sciences (AIIMS), Rishikesh, India; 8Department of General Surgery, All India Institute of Medical Sciences (AIIMS), Rishikesh, India Correspondence: Prasan Kumar Panda Department of Medicine (Infectious Disease Division), All India Institute of Medical Sciences (AIIMS), Sixth Floor, College Block, Rishikesh, 249203, India Tel +91 9868999488 Email motherprasanna@rediffmail.com Purpose: Definitive antiviral treatment is not available for COVID-19 infection, with the exception of remdesivir, which still evokes many doubts. Various monotherapy or combina­ tion therapies with antivirals or other agents have been tried. The present study aims to evaluate the therapeutic potential of hydroxychloroquine and lopinavir–ritonavir in combina­ tion with ribavirin in mild–severe COVID-19. Patients and Methods: A single-center, open-label, parallel-arm, stratified randomized controlled trial evaluated the therapeutic potential of combination antiviral therapies. Enrolled patients in the severe category were randomized into three groups: (A) standard treatment, (B) hydroxychloroquine+ribavirin+standard treatment, or (C) lopinavir+ritonavir +ribavirin+standard treatment; while the non-severe category comprised two groups: (A) standard treatment or (B) hydroxychloroquine+ribavirin. Combination antivirals were given for 10 days and followed for 28 days. The primary endpoints were safety, symptomatic and laboratory recovery of organ dysfunctions, and time to SARS-CoV-2 RT-PCR negative report. Results: In total, 111 patients were randomized: 24, 23, and 24 in severe categories A, B, and C, respectively, and 20 in each of the non-severe groups. Two patients receiving ribavirin experienced drug induced liver injury, and another developed QT prolongation after hydro­ xychloroquine. In the severe category, 47.6%, 55%, and 30.09% in A, B, and C groups, respectively, showed symptomatic recovery, compared to 93.3% and 86.7% in A and B groups, respectively, in the non-severe category at 72 hours (P>0.05). Conclusion: Though the results failed to show statistical superiority of the antiviral combination therapies to that of the standard therapy in both the severe and..
Late treatment
is less effective
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