Sarhan: Efficacy of the early treatment with tocilizumab-hydroxychloroquine and tocilizumab-remdesivir in severe COVID-19 Patients [HCQ]

Efficacy of the early treatment with tocilizumab-hydroxychloroquine and tocilizumab-remdesivir in severe COVID-19 Patients

Sarhan et al., Journal of Infection and Public Health, doi:10.1016/j.jiph.2021.10.024, NCT04779047 (history)

Sarhan et al., Efficacy of the early treatment with tocilizumab-hydroxychloroquine and tocilizumab-remdesivir in severe.., Journal of Infection and Public Health, doi:10.1016/j.jiph.2021.10.024, NCT04779047

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Small 108 patient RCT comparing HCQ vs. remdesivir in very late stage treatment. All patients received tocilizumab. There were significant unadjusted baseline differences in ventilation and ICU admission. NCT04779047 (history). REC-H-PhBSU-21011.

Although the 26% lower mortality is not statistically significant, it is consistent with the significant 22% lower mortality [18‑27%] from meta analysis of the 232 mortality results to date. This study is excluded in the after exclusion results of meta analysis: very late stage, >50% on oxygen/ventilation at baseline; significant unadjusted differences between groups.

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risk of death, 25.7% lower, RR 0.74, p = 0.39, treatment 12 of 56 (21.4%), control 15 of 52 (28.8%), NNT 13.

risk of no hospital discharge, 25.7% lower, RR 0.74, p = 0.39, treatment 12 of 56 (21.4%), control 15 of 52 (28.8%), NNT 13.

hospitalization time, 25.0% higher, relative time 1.25, p = 0.06, treatment 56, control 52.

Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates

Sarhan et al., 2 Nov 2021, Randomized Controlled Trial, Egypt, peer-reviewed, 8 authors, study period 1 October, 2020 - 10 March, 2021, this trial compares with another treatment - results may be better when compared to placebo, trial NCT04779047 (history).

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Abstract: Journal Pre-proof Efﬁcacy of the early treatment with tocilizumab-hydroxychloroquine and tocilizumab-remdesivir in severe COVID-19 Patients Rania M. Sarhan, Hadeer S. Harb, Ahmed E. Abou Warda, Mounir M. Salem-Bekhit, Faiyaz Shakeel, Sami A. Alzahrani, Yasmin M. Madney, Marian S. Boshra PII: S1876-0341(21)00345-2 DOI: https://doi.org/10.1016/j.jiph.2021.10.024 Reference: JIPH 1747 To appear in: Journal of Infection and Public Health Received Date: 10 July 2021 Revised Date: 12 October 2021 Accepted Date: 25 October 2021 Please cite this article as: Sarhan RM, Harb HS, Abou Warda AE, Salem-Bekhit MM, Shakeel F, Alzahrani SA, Madney YM, Boshra MS, Efﬁcacy of the early treatment with tocilizumab-hydroxychloroquine and tocilizumab-remdesivir in severe COVID-19 Patients, Journal of Infection and Public Health (2021), doi: https://doi.org/10.1016/j.jiph.2021.10.024 This is a PDF ﬁle of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the deﬁnitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its ﬁnal form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. © 2020 Published by Elsevier. Efficacy of the early treatment with tocilizumab- hydroxychloroquine and tocilizumab-remdesivir in severe COVID-19 Patients Short title: Effect of different antiviral and anti-inflammatory drugs in COVID-19 Patients 1 Rania M Sarhan , 1 Hadeer S. Harb, 2 Ahmed E. Abou Warda, 3,4 Mounir M. Salem-Bekhit, Shakeel, 3 Sami Ali Alzahrani, 1 Yasmin M. Madney, 1 Marian S. Boshra 3 Faiyaz 1Clinical oo f Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Benisuef, Egypt. 2Clinical Pharmacy Department, Faculty of Pharmacy, October 6 University, Giza, Egypt. 3Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh, 11451, Saudi Arabia. 4Department of Microbiology and Immunology, Faculty of Pharmacy, Al-Azhar University, Cairo, Egypt. pr Corresponding author: Rania M Sarhan ORCID Number: 0000-0002-0781-6454 e- Fax: 0020235676109 Mobile phone: 0201008789509 Pr Mailing address: Ahmed Hegazy Street, Faculty of pharmacy, Beni-Suef, Egypt Email: raniamohammad87@yahoo.com ur n al Abstract Background: The effectiveness of the best combination between different antiviral and anti-inflammatory drugs stills an interest in the treatment of COVID19 infection. Jo Patients and Methods: A prospective randomized cohort study comprised 108 adult patients with confirmed PCR COVID 19 infection with systemic hyper inflammation state, divided into two groups according to the treatment regimen, 56 in the tocilizumab- hydroxychloroquine (TCZ-HCQ) treatment, and 52 in the tocilizumabremdesivir (TCZ-RMV) treatment. The first group received a combination of I.V. TCZ (400 -800 mg every 24 hours for only two doses) and HCQ (400 mg twice in the first day then 200 mg twice for 5 days) while the second group of patients received I.V. RMV of 200 mg on day 1 followed by 100 mg once daily infused over 60 minutes for 5 days with the same TCZ regimen used in the first group. All clinical parameters and laboratory investigations were assessed before and after..

Late treatment
is less effective

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