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0 0.5 1 1.5 2+ Progression -196% Improvement Relative Risk Hospitalization 52% Case 14% Case (b) 6% HCQ for COVID-19  HOPE  Prophylaxis  RCT Is pre-exposure prophylaxis with HCQ beneficial for COVID-19? RCT 414 patients in India (June 2020 - February 2021) Trial underpowered to detect differences Tirupakuzhi Vijayaraghavan et al., BMJ.., Jun 2022 Favors HCQ Favors control

Hydroxychloroquine plus personal protective equipment versus personal protective equipment alone for the prevention of laboratory-confirmed COVID-19 infections among healthcare workers: a multicentre, parallel-group randomised controlled trial from India

Tirupakuzhi Vijayaraghavan et al., BMJ Open, doi:10.1136/bmjopen-2021-059540, HOPE, CTRI/2020/05/025067
Jun 2022  
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HCQ for COVID-19
1st treatment shown to reduce risk in March 2020
*, now known with p < 0.00000000001 from 421 studies, recognized in 42 countries.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
3,800+ studies for 60+ treatments.
Low-dose prophylaxis RCT with low-risk healthcare workers in India, showing no significant differences. Symptomatic case results are not provided. Followup was over 6 months, however treatment ended after 3 months. 21% of patients discontinued treatment before 3 months (Table S2).
risk of progression, 196.2% higher, RR 2.96, p = 1.00, treatment 1 of 211 (0.5%), control 0 of 203 (0.0%), continuity correction due to zero event (with reciprocal of the contrasting arm), ICU/HDU.
risk of hospitalization, 51.9% lower, RR 0.48, p = 0.62, treatment 1 of 211 (0.5%), control 2 of 203 (1.0%), NNT 196.
risk of case, 14.2% lower, RR 0.86, p = 0.73, treatment 11 of 211 (5.2%), control 12 of 203 (5.9%), NNT 143, adjusted per study, odds ratio converted to relative risk, confirmed cases, multivariable.
risk of case, 5.7% lower, RR 0.94, p = 0.90, treatment 12 of 211 (5.7%), control 12 of 203 (5.9%), NNT 446, adjusted per study, odds ratio converted to relative risk, multivariable.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Tirupakuzhi Vijayaraghavan et al., 1 Jun 2022, Randomized Controlled Trial, India, peer-reviewed, mean age 32.1, 21 authors, study period 29 June, 2020 - 4 February, 2021, trial CTRI/2020/05/025067 (HOPE). Contact:
This PaperHCQAll
Hydroxychloroquine plus personal protective equipment versus personal protective equipment alone for the prevention of laboratory-confirmed COVID-19 infections among healthcare workers: a multicentre, parallel-group randomised controlled trial from India
Bharath Kumar Tirupakuzhi Vijayaraghavan, Vivekanand Jha, Dorrilyn Rajbhandari, Sheila Nainan Myatra, Arpita Ghosh, Amritendu Bhattacharya, Sumaiya Arfin, Abhinav Bassi, Lachlan Hugh Donaldson, Naomi E Hammond, Oommen John, Rohina Joshi, Mallikarjuna Kunigari, Cynthia Amrutha, Syed Haider Mehdi Husaini, Subir Ghosh, Santosh Kumar Nag, Hari Krishnan Selvaraj, Viny Kantroo, Kamal D Shah, Balasubramanian Venkatesh
BMJ Open, doi:10.1136/bmjopen-2021-059540
Hydroxychloroquine plus personal protective equipment versus personal protective equipment alone for the prevention of laboratoryconfirmed COVID-19 infections among healthcare workers: a multicentre, parallel-group randomised controlled trial from India. BMJ Open 2022;12:e059540.
Ethics approval This study involves human participants and was approved by The George Institute Ethics Committee (reference number: 08-2020). Participants gave informed consent to participate in the study before taking part. Provenance and peer review Not commissioned; externally peer reviewed. Data availability statement Data are available upon reasonable request. Deidentified patient data will be made available beginning 6 months after publication of the study and ending at 2 years. All requests for data sharing must be accompanied by a formal request, a study proposal with clear statement of aims and hypotheses and a statistical analysis plan. All applications will be assessed by the HOPE Management Committee. Applications from investigators with suitable academic capability to conduct the proposed work will be given consideration. Any proposal will require approval from the ethics committee which approved the conduct of this trial prior to sharing of any patient data. If a proposal is approved, a signed data transfer agreement will be required before data sharing. Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated..
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