Universidad Peruana Cayetano Heredia

Repurposed Antiviral Drugs for Covid-19 - Interim WHO Solidarity Trial Results

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dc.contributor.author Pan, Hongchao
dc.contributor.author Peto, Richard
dc.contributor.author Henao-Restrepo, Ana-Maria
dc.contributor.author Preziosi, Marie-Pierre
dc.contributor.author Sathiyamoorthy, Vasee
dc.contributor.author Abdool Karim, Quarraisha
dc.contributor.author Alejandria, Marissa M.
dc.contributor.author Hernández García, César
dc.contributor.author Kieny, Marie-Paule
dc.contributor.author Malekzadeh, Reza
dc.contributor.author Murthy, Srinivas
dc.contributor.author Reddy, K. Srinath
dc.contributor.author Roses Periago, Mirta
dc.contributor.author Abi Hanna, Pierre
dc.contributor.author Ader, Florence
dc.contributor.author Al-Bader, Abdullah M.
dc.contributor.author Alhasawi, Almonther
dc.contributor.author Allum, Emma
dc.contributor.author Alotaibi, Athari
dc.contributor.author Alvarez-Moreno, Carlos A.
dc.contributor.author Appadoo, Sheila
dc.contributor.author Asiri, Abdullah
dc.contributor.author Aukrust, Pål
dc.contributor.author Barratt-Due, Andreas
dc.contributor.author Bellani, Samir
dc.contributor.author Branca, Mattia
dc.contributor.author Cappel-Porter, Heike B. C.
dc.contributor.author Cerrato, Nery
dc.contributor.author Chow, Ting S.
dc.contributor.author Como, Najada
dc.contributor.author Eustace, Joe
dc.contributor.author Garcia Funegra, Patricia Jannet
dc.contributor.author Godbole, Sheela
dc.contributor.author Gotuzzo Herencia, José Eduardo
dc.contributor.author Griskevicius, Laimonas
dc.contributor.author Hamra, Rasha
dc.contributor.author Hassan, Mariam
dc.contributor.author Hassany, Mohamed
dc.contributor.author Hutton, David
dc.contributor.author Irmansyah, Irmansyah
dc.contributor.author Jancoriene, Ligita
dc.contributor.author Kirwan, Jana
dc.contributor.author Kumar, Suresh
dc.contributor.author Lennon, Peter
dc.contributor.author Lopardo, Gustavo
dc.contributor.author Lydon, Patrick
dc.contributor.author Magrini, Nicola
dc.contributor.author Maguire, Teresa
dc.contributor.author Manevska, Suzana
dc.contributor.author Manuel, Oriol
dc.contributor.author McGinty, Sibylle
dc.contributor.author Medina, Marco T.
dc.contributor.author Mesa Rubio, María L.
dc.contributor.author Miranda-Montoya, Maria C.
dc.contributor.author Nel, Jeremy
dc.contributor.author Nunes, Estevao P.
dc.contributor.author Perola, Markus
dc.contributor.author Portolés, Antonio
dc.contributor.author Rasmin, Menaldi R.
dc.contributor.author Raza, Aun
dc.contributor.author Rees, Helen
dc.contributor.author Reges, Paula P. S.
dc.contributor.author Rogers, Chris A.
dc.contributor.author Salami, Kolawole
dc.contributor.author Salvadori, Marina I.
dc.contributor.author Sinani, Narvina
dc.contributor.author Sterne, Jonathan A. C.
dc.contributor.author Stevanovikj, Milena
dc.contributor.author Tacconelli, Evelina
dc.contributor.author Tikkinen, Kari A. O.
dc.contributor.author Trelle, Sven
dc.contributor.author Zaid, Hala
dc.contributor.author Røttingen, John-Arne
dc.contributor.author Swaminathan, Soumya
dc.date.accessioned 2021-04-13T20:50:57Z
dc.date.available 2021-04-13T20:50:57Z
dc.date.issued 2020
dc.identifier.uri https://hdl.handle.net/20.500.12866/9103
dc.description.abstract BACKGROUND: World Health Organization expert groups recommended mortality trials of four repurposed antiviral drugs - remdesivir, hydroxychloroquine, lopinavir, and interferon beta-1a - in patients hospitalized with coronavirus disease 2019 (Covid-19). METHODS: We randomly assigned inpatients with Covid-19 equally between one of the trial drug regimens that was locally available and open control (up to five options, four active and the local standard of care). The intention-to-treat primary analyses examined in-hospital mortality in the four pairwise comparisons of each trial drug and its control (drug available but patient assigned to the same care without that drug). Rate ratios for death were calculated with stratification according to age and status regarding mechanical ventilation at trial entry. RESULTS: At 405 hospitals in 30 countries, 11,330 adults underwent randomization; 2750 were assigned to receive remdesivir, 954 to hydroxychloroquine, 1411 to lopinavir (without interferon), 2063 to interferon (including 651 to interferon plus lopinavir), and 4088 to no trial drug. Adherence was 94 to 96% midway through treatment, with 2 to 6% crossover. In total, 1253 deaths were reported (median day of death, day 8; interquartile range, 4 to 14). The Kaplan-Meier 28-day mortality was 11.8% (39.0% if the patient was already receiving ventilation at randomization and 9.5% otherwise). Death occurred in 301 of 2743 patients receiving remdesivir and in 303 of 2708 receiving its control (rate ratio, 0.95; 95% confidence interval [CI], 0.81 to 1.11; P = 0.50), in 104 of 947 patients receiving hydroxychloroquine and in 84 of 906 receiving its control (rate ratio, 1.19; 95% CI, 0.89 to 1.59; P = 0.23), in 148 of 1399 patients receiving lopinavir and in 146 of 1372 receiving its control (rate ratio, 1.00; 95% CI, 0.79 to 1.25; P = 0.97), and in 243 of 2050 patients receiving interferon and in 216 of 2050 receiving its control (rate ratio, 1.16; 95% CI, 0.96 to 1.39; P = 0.11). No drug definitely reduced mortality, overall or in any subgroup, or reduced initiation of ventilation or hospitalization duration. CONCLUSIONS: These remdesivir, hydroxychloroquine, lopinavir, and interferon regimens had little or no effect on hospitalized patients with Covid-19, as indicated by overall mortality, initiation of ventilation, and duration of hospital stay. en_US
dc.language.iso eng
dc.publisher Massachusetts Medical Society
dc.relation.ispartofseries New England Journal of Medicine
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Adenosine Monophosphate en_US
dc.subject adenosine phosphate en_US
dc.subject adult en_US
dc.subject aged en_US
dc.subject Aged en_US
dc.subject alanine en_US
dc.subject Alanine en_US
dc.subject Antiviral Agents en_US
dc.subject antivirus agent en_US
dc.subject Article en_US
dc.subject artificial ventilation en_US
dc.subject beta1a interferon en_US
dc.subject clinical trial en_US
dc.subject combination drug therapy en_US
dc.subject comparative study en_US
dc.subject controlled study en_US
dc.subject coronavirus disease 2019 en_US
dc.subject COVID-19 en_US
dc.subject death en_US
dc.subject drug clearance en_US
dc.subject drug repositioning en_US
dc.subject drug therapy en_US
dc.subject Drug Therapy, Combination en_US
dc.subject drug withdrawal en_US
dc.subject extracorporeal oxygenation en_US
dc.subject female en_US
dc.subject Female en_US
dc.subject health care quality en_US
dc.subject hospital mortality en_US
dc.subject Hospital Mortality en_US
dc.subject hospital patient en_US
dc.subject hospitalization en_US
dc.subject Hospitalization en_US
dc.subject human en_US
dc.subject Humans en_US
dc.subject hydroxychloroquine en_US
dc.subject Hydroxychloroquine en_US
dc.subject intention to treat analysis en_US
dc.subject Intention to Treat Analysis en_US
dc.subject Interferon beta-1a en_US
dc.subject Kaplan Meier method en_US
dc.subject Kaplan-Meier Estimate en_US
dc.subject length of stay en_US
dc.subject Length of Stay en_US
dc.subject lopinavir en_US
dc.subject Lopinavir en_US
dc.subject major clinical study en_US
dc.subject male en_US
dc.subject Male en_US
dc.subject middle aged en_US
dc.subject Middle Aged en_US
dc.subject mortality en_US
dc.subject multicenter study en_US
dc.subject priority journal en_US
dc.subject randomized controlled trial en_US
dc.subject remdesivir en_US
dc.subject Respiration, Artificial en_US
dc.subject ritonavir en_US
dc.subject treatment duration en_US
dc.subject treatment failure en_US
dc.subject Treatment Failure en_US
dc.subject World Health Organization en_US
dc.subject Adenosine Monophosphate/*analogs & derivatives/therapeutic use en_US
dc.subject Alanine/*analogs & derivatives/therapeutic use en_US
dc.subject Antiviral Agents/administration & dosage/adverse effects/*therapeutic use en_US
dc.subject COVID-19/*drug therapy/mortality en_US
dc.subject Hydroxychloroquine/*therapeutic use en_US
dc.subject Interferon beta-1a/*therapeutic use en_US
dc.subject Lopinavir/*therapeutic use en_US
dc.title Repurposed Antiviral Drugs for Covid-19 - Interim WHO Solidarity Trial Results en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1056/NEJMoa2023184
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.00
dc.relation.issn 1533-4406


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