126
Views
0
CrossRef citations to date
0
Altmetric
Meta-analysis

Clinical outcomes, virological efficacy and safety of nitazoxanide in the treatment of patients with COVID-19: a systematic review and meta-analysis of randomized controlled trials

, , ORCID Icon, &
Pages 1615-1622 | Received 21 Sep 2022, Accepted 25 Oct 2022, Published online: 03 Nov 2022

References

  • Lai CC, Shih TP, Ko WC, et al. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): the epidemic and the challenges. Int J Antimicrob Agents. 2020;55(3):105924.
  • World Health Organization. Accessed on 2022 Oct 24. https://covid19.who.int/.
  • Lai CC, Chen IT, Chao CM, et al. COVID-19 vaccines: concerns beyond protective efficacy and safety. Expert Rev Vaccines. 2021;20(8):1013–1025.
  • Lai CC, Yen MY, Lee PI, et al. How to Keep COVID-19 at Bay: a Taiwanese Perspective. J Epidemiol Glob Health. 2021;11(1):1–5.
  • Lai CC, Wang YH, Chen KH, et al. The clinical efficacy and safety of anti-viral agents for non-hospitalized patients with COVID-19: a systematic review and network meta-analysis of randomized controlled trials. Viruses. 2022;14(8):1706.
  • Hammond J, Leister-Tebbe H, Gardner A, et al. Oral nirmatrelvir for high-risk, nonhospitalized adults with COVID-19. N Engl J Med. 2022;386(15):1397–1408.
  • Jayk Bernal A, Gomes da Silva MM, Musungaie DB, et al. Molnupiravir for oral treatment of COVID-19 in nonhospitalized patients. N Engl J Med. 2022;386(6):509–520.
  • Gottlieb RL, Vaca CE, Paredes R, et al. Early remdesivir to prevent progression to severe COVID-19 in outpatients. N Engl J Med. 2022;386(4):305–315.
  • Lai CC, Chen CH, Wang CY, et al. Clinical efficacy and safety of remdesivir in patients with COVID-19: a systematic review and network meta-analysis of randomized controlled trials. J Antimicrob Chemother. 2021;76(8):1962–1968.
  • National Institutes of Health. https://www.covid19treatmentguidelines.nih.gov/ Accessed on 2022 Oct 24).
  • Hsu CK, Chen CY, Chen WC, et al. Effect of sofosbuvir-based treatment on clinical outcomes of patients with COVID-19: a systematic review and meta-analysis of randomised controlled trials. Int J Antimicrob Agents. 2022;59(3):106545.
  • Lai CC, Chao CM, Hsueh PR. Clinical efficacy of antiviral agents against coronavirus disease 2019: a systematic review of randomized controlled trials. J Microbiol Immunol Infect. 2021;54(5):767–775.
  • Lan SH, Lai CC, Chang SP, et al. Favipiravir-based treatment for outcomes of patients with COVID-19: a systematic review and meta-analysis of randomized controlled trials. Expert Rev Clin Pharmacol. 2022;15(6):759–766.
  • Rossignol JF, La Frazia S, Chiappa L, et al. Thiazolides, a new class of anti-influenza molecules targeting viral hemagglutinin at the post-translational level. J Biol Chem. 2009;284(43):29798–29808.
  • Haffizulla J, Hartman A, Hoppers M, et al. Effect of nitazoxanide in adults and adolescents with acute uncomplicated influenza: a double-blind, randomised, placebo-controlled, phase 2b/3 trial. Lancet Infect Dis. 2014;14(7):609–618 .
  • Stachulski AV, Taujanskas J, Pate SL, et al. Therapeutic potential of nitazoxanide: an appropriate choice for repurposing versus SARS-CoV-2? ACS Infect Dis. 2021;7(6):1317–1331.
  • Rossignol JF. Nitazoxanide, a new drug candidate for the treatment of middle east respiratory syndrome coronavirus. J Infect Public Health. 2016;9(3):227–230.
  • Piacentini S, La Frazia S, Riccio A, et al. Nitazoxanide inhibits paramyxovirus replication by targeting the fusion protein folding: role of glycoprotein-specific thiol oxidoreductase ERp57. Sci Rep. 2018;8(1):10425.
  • Jasenosky LD, Cadena C, Mire CE, et al. The FDA-Approved oral drug nitazoxanide amplifies host antiviral responses and inhibits Ebola virus. iScience. 2019;19:1279–1290.
  • Martins-Filho PR, Barreto-Alves JA, Fakhouri R. Potential role for nitazoxanide in treating SARS-CoV-2 infection. Am J Physiol Lung Cell Mol Physiol. 2020;319(1):L35–l36.
  • Bobrowski T, Chen L, Eastman RT, et al. Synergistic and antagonistic drug combinations against SARS-CoV-2. Mol Ther. 2021;29(2):873–885.
  • Lian E, McAlister C, Ramirez G, et al. Triple combination nitazoxanide, ribavirin, and hydroxychloroquine results in the multiplicative reduction of in vitro SARS-CoV-2 viral replication. bioRxiv. 2020 Nov 26;11.25.399055.
  • Wang M, Cao R, Zhang L, et al. Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro. Cell Res. 2020;30(3):269–271.
  • Rocco PRM, Silva PL, Cruz FF, et al. Early use of nitazoxanide in mild COVID-19 disease: randomised, placebo-controlled trial. Eur Respir J. 2021;58(1):2003725.
  • Rocco PRM, Silva PL, Cruz FF, et al. Nitazoxanide in patients hospitalized with COVID-19 pneumonia: a multicentre, randomized, double-blind, placebo-controlled trial. Front Med (Lausanne). 2022;9:844728.
  • Rossignol JF, Bardin MC, Fulgencio J, et al. A randomized double-blind placebo-controlled clinical trial of nitazoxanide for treatment of mild or moderate COVID-19. EClinicalMedicine. 2022;45:101310.
  • Blum VF, Cimerman S, Hunter JR, et al. Nitazoxanide superiority to placebo to treat moderate COVID-19 - A Pilot prove of concept randomized double-blind clinical trial. EClinicalMedicine. 2021;37:100981.
  • Medhat MA, El-Kassas M, Karam-Allah H, et al. Sofosbuvir/ledipasvir in combination or nitazoxanide alone are safe and efficient treatments for COVID-19 infection: a randomized controlled trial for repurposing antivirals. Arab J Gastroenterol. 2022;23(3):165–171.
  • Page MJ, McKenzie JE, Bossuyt PM, et al. Updating guidance for reporting systematic reviews: development of the PRISMA 2020 statement. J Clin Epidemiol. 2021;134:103–112.
  • Sterne JAC, Savović J, Page MJ, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. Bmj. 2019;366:l4898.
  • Martins-Filho PR, Do Nascimento-Júnior EM, Barreto-Alves JA, et al. Efficacy and safety of nitazoxanide in treating SARS-CoV-2 infection: a systematic review and meta-analysis of blinded, placebo-controlled, randomized clinical trials. Eur J Clin Pharmacol. 2022;78(11):1813–1821.
  • Silva M, Espejo A, Pereyra M L, et al. Efficacy of nitazoxanide in reducing the viral load in COVID-19 patients. Randomized, placebo-controlled, single-blinded, parallel group, pilot study. medRxiv. 2021 Mar 5;03.03.212
  • Walker LE, FitzGerald R, Saunders G, et al. An open label, adaptive, phase 1 trial of high-dose oral nitazoxanide in healthy volunteers: an antiviral candidate for SARS-CoV-2. Clin Pharmacol Ther. 2022;111(3):585–594.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.