Early Start of Oral Clarithromycin Is Associated with Better Outcome in COVID-19 of Moderate Severity: The ACHIEVE Open-Label Single-Arm Trial.
Infect Dis Ther
; 10(4): 2333-2351, 2021 Dec.
Article
in English
| MEDLINE | ID: covidwho-1345213
ABSTRACT
INTRODUCTION:
The anti-inflammatory effect of macrolides prompted the study of oral clarithromycin in moderate COVID-19.METHODS:
An open-label non-randomized trial in 90 patients with COVID-19 of moderate severity was conducted between May and October 2020. The primary endpoint was defined at the end of treatment (EOT) as no need for hospital re-admission and no progression into lower respiratory tract infection (LRTI) for patients with upper respiratory tract infection and as at least 50% decrease of the respiratory symptoms score without progression into severe respiratory failure (SRF) for patients with LRTI. Viral load, biomarkers, the function of mononuclear cells and safety were assessed.RESULTS:
The primary endpoint was attained in 86.7% of patients treated with clarithromycin (95% CIs 78.1-92.2%); this was 91.7% and 81.4% among patients starting clarithromycin the first 5 days from symptoms onset or later (odds ratio after multivariate analysis 6.62; p 0.030). The responses were better for patients infected by non-B1.1 variants. Clarithromycin use was associated with decreases in circulating C-reactive protein, tumour necrosis factor-alpha and interleukin (IL)-6; by increase of production of interferon-gamma and decrease of production of interleukin-6 by mononuclear cells; and by suppression of SARS-CoV-2 viral load. No safety concerns were reported.CONCLUSIONS:
Early clarithromycin treatment provides most of the clinical improvement in moderate COVID-19. TRIAL REGISTRATION ClinicalTrials.gov, NCT04398004.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Type of study:
Experimental Studies
/
Prognostic study
/
Randomized controlled trials
Topics:
Variants
Language:
English
Journal:
Infect Dis Ther
Year:
2021
Document Type:
Article
Affiliation country:
S40121-021-00505-8
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