Lack of Effectiveness of Repurposed Drugs for COVID-19 Treatment

Martı́nez, Miguel Ángel

doi:10.3389/fimmu.2021.635371

Cited by 53 publications

(47 citation statements)

References 25 publications

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“…There is still no optimal approach for COVID-19 management and the repurposing potential of several drugs, including remdesivir, ivermectin, colchicine, favipiravir, lopinavir-ritonavir, ribavirin, interferon, CQ and HCQ, have been tested for prevention and treatment of this disease. Despite drug repurposing played a critical role in the identification of rapidly available therapeutic solutions against SARS-CoV-2 infection 37 , to date, only remdesivir and tocilizumab were approved by the US Food and Drug Administration (FDA) and other health agencies for the treatment of hospitalized patients with COVID-19. The evidence for suggesting repurposing HCQ is based on observations of decreased viral replication in vitro 1 but results from clinical data are contrasting.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of hydroxychloroquine as pre-and post-exposure prophylaxis and treatment of COVID-19: A systematic review and meta-analysis of blinded, placebo-controlled, randomized clinical trials.

Martins-Filho

Ferreira

Heimfarth

et al. 2021

The Lancet Regional Health - Americas

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BACKGROUND Hydroxychloroquine (HCQ) is an anti-malarial and immunomodulatory drug considered a potential candidate for drug repurposing in COVID-19 due to their in vitro antiviral activity against SARS-CoV-2. Despite the potential antiviral effects and anti-inflammatory profile, the results based on clinical studies are contradictory. Therefore, the quality of the decision-making process from meta-analyses summarizing the available evidence selecting studies with different designs and unblinded trials is limited. The aim of this study was to synthesize the best evidence on the efficacy and safety of HCQ as pre-and post-exposure prophylaxis and treatment of non-hospitalized and hospitalized patients with COVID-19. METHODS Searches were performed in PubMed, Web of Science, Embase, Lilacs, the website ClinicalTrials.gov and the preprint server medRxiv from January 1, 2020 to May 17, 2021. The following elements were used to define eligibility criteria: (1) Population: individuals at high-risk of exposure to SARS-CoV-2 (pre-exposure), individuals who had close contact with a positive or probable case of COVID-19 (post-exposure), non-hospitalized patients with COVID-19 and hospitalized patients with COVID-19; (2) Intervention: HCQ; (3) Comparison: placebo; (4) Outcomes: incidence of SARS-CoV-2 infection, need for hospitalization, length of hospital stay, need for invasive mechanical ventilation (MV), death, and adverse events; and (5) Study type: blinded, placebo-controlled, randomized clinical trials (RCTs). Risk of bias was judged according to the Cochrane guidelines for RCTs. Treatment effects were reported as relative risk (RR) for dichotomous variables and mean difference (MD) for continuous variables with 95% confidence intervals (CI). We used either a fixed or random-effects model to pool the results of individual studies depending on the presence of heterogeneity. The GRADE system was used to evaluate the strength of evidence between use of HCQ and the outcomes of interest. FINDINGS Fourteen blinded, placebo-controlled RCTs were included in this meta-analysis. Four trials (1942 patients: HCQ = 1271; placebo = 671) used HCQ as a prophylactic medication pre-exposure to COVID-19, two (1650 patients: HCQ = 821; placebo = 829) as a prophylactic medication post-exposure to COVID-19, three (1018 patients: HCQ = 497; placebo = 521) as treatment for non-hospitalized patients, and five (1138 patients: HCQ = 572; placebo = 566) as treatment for hospitalized patients with COVID-19. We found no decreased risk of SARS-CoV-2 infection among individuals receiving HCQ as pre-exposure (RR = 0.90; 95% CI 0.46 to 1.77) or post-exposure (RR = 0.96; 95% CI 0.72 to 1.29) prophylaxis to prevent COVID-19. There was no significant decreased risk of hospitalization for outpatients with SARS-CoV-2 infection (RR = 0.64; 95% CI 0.33 to 1.23) and no decreased risk of MV (RR = 0.81; 95% CI 0.49 to 1.34) and death (RR = 1.05; 95% CI 0.62 to...

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of hydroxychloroquine as pre-and post-exposure prophylaxis and treatment of COVID-19: A systematic review and meta-analysis of blinded, placebo-controlled, randomized clinical trials.

Martins-Filho

Ferreira

Heimfarth

et al. 2021

The Lancet Regional Health - Americas

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show abstract

“…Until now, an effective treatment for the disease has not been developed yet (Song et al 2020 ). However, to quickly prevent the spread, morbidity and mortality of COVID-19, the repurposing of various drugs has been adopted and many trials have been conducted (Martinez 2021 ). Hydroxychloroquine has been one of these drugs.…”

Section: Discussionmentioning

confidence: 99%

Effects of hydroxychloroquine and its metabolites in patients with connective tissue diseases

et al. 2021

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“…IFN is related to the induction of innate immunity and SARS-CoV-2 bypassing natural innate immunity for infecting and inducing COVID-19 in normal individuals. 31 , 32 Thus, the usage of IFN even for a short duration may benefit in controlling infection with SARS-CoV-2.…”

Section: Discussionmentioning

confidence: 99%

Role of Pegylated Interferon in Patients with Chronic Liver Diseases in the Context of SARS-CoV-2 Infection

Akbar

Mahtab

Aguilar

et al. 2021

Euroasian Journal of Hepato-Gastroenterology

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Lack of Effectiveness of Repurposed Drugs for COVID-19 Treatment

Cited by 53 publications

References 25 publications

Efficacy and safety of hydroxychloroquine as pre-and post-exposure prophylaxis and treatment of COVID-19: A systematic review and meta-analysis of blinded, placebo-controlled, randomized clinical trials.

Efficacy and safety of hydroxychloroquine as pre-and post-exposure prophylaxis and treatment of COVID-19: A systematic review and meta-analysis of blinded, placebo-controlled, randomized clinical trials.

Effects of hydroxychloroquine and its metabolites in patients with connective tissue diseases

Role of Pegylated Interferon in Patients with Chronic Liver Diseases in the Context of SARS-CoV-2 Infection

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