Favipiravir in patients hospitalised with COVID-19 (PIONEER trial): a multicentre, open-label, phase 3, randomised controlled trial of early intervention versus standard care
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , , , , , , , , , , , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da FIOCRUZ (ARCA) |
Texto Completo: | https://www.arca.fiocruz.br/handle/icict/57785 |
Resumo: | The PIONEER trial group: Authors List - Damon Foster, Nadia Shabbir, Simon Connolly, Andrea Cartier, Sajjida Jaffer, Carmen Winpenny, Doris Daby, Samuel Pepper, Christine Adamson, Jamie Carungcong, Kribashnie Nundlall, Serge Fedele, Pardina Samson-Fessale, Alexandra Schoolmeesters, Laura Gomes de Almeida Martins, Rhian Bull, Patricia Correia Da Costa, Carina Bautista, Maria Eleanor Flores, Shameera Maheswaran, Lester Macabodbod, Rosalie Houseman, Marie-Louise Svensson, Amrinder Sayan, Carrie Fung, Justin Garner, Dilys Lai, Mark Nelson, Luke Moore, Shewta Gidwani, Gary Davies, Beatrice Ouma, Clovis Salinos, Jad Salha, Redasaad Yassein, Abdul Abbasi, Metod Oblak, Angelica Steward, Mini Thankachen, Amy Barker, Candida Fernandes, Veronica Beatriz, Leah Flores, Alfredo Soler-Carracedo, Alessandra Rocca, Shameera Maheswaran, Carmela Martella, Charlotte Lloyd, Ciara Nolan, Latoya Horsford, Laura Martins, Lervina Thomas, Mark Winstanley, Miriam Bourke, Nicholas Branch, Orhan Orhan, Richard Morton, Sangeetha Saunder, Shashank Patil, Stephen Hughes, Wu Zhe, Ashley De Leon, Ayaan Farah, Grace Rya, Katrin Alizadeh, Kirsty Leong, Laure Trepte, Nupur Goel, Patrick McGown, Ursula Kirwan, Tamiris Vilela Baião, Luana Marins, Sandro Nazer, Raquel Malaguthi de Souza, Marcella Feitosa, Flavia Lessa, Elizabeth Silva de Magalhães, Jamile Costenaro, Rita de Cassia Alves Lira, Ana Carolina, Andréa Cauduro de Castro, Andre Machado Da Silva, Dimas Kliemann, Rita De Cassia Alves Lira, Gemma Walker, Donna Norton, Vicki Lowthorpe, Monica Ivan, Patrick Lillie, Nicholas Easom, Juan Sierra Madero, Álvaro López Iñiguez, Guadalupe Patricia Muñuzuri Nájera, Claudia Paola Alarcón Murra, Audelia Alanis Vega, Teresa Muñoz Trejo, Olivia Pérez Rodríguez. |
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Shah, Pallav L.Orton, Christopher M.Grinsztejn, BeatrizDonaldson, Gavin C.Crabtree Ramírez, BrendaTonkin, JamesSantos, Breno R.Cardoso, Sandra W.Ritchie, Andrew I.Conway, FrancescaRiberio, Maria P. D.Wiseman, Dexter J.Tana, AnandVijayakumar, BavithraCaneja, CielitoLeaper, CraigMann, BobbySamson, AndaBhavsar, Pankaj K.Boffito, MartaJohnson, Mark R.Pozniak, AntonPelly, Michael2023-04-14T14:00:40Z2023-04-14T14:00:40Z2022SHAH, Pallav L. et al. Favipiravir in patients hospitalised with COVID-19 (PIONEER trial): a multicentre, open-label, phase 3, randomised controlled trial of early intervention versus standard care. The Lancet Respiratory Medicine, p. 1-10, Dec. 14, 2022.0140-6736https://www.arca.fiocruz.br/handle/icict/5778510.1016/S2213-2600(22)00412-XThe PIONEER trial group: Authors List - Damon Foster, Nadia Shabbir, Simon Connolly, Andrea Cartier, Sajjida Jaffer, Carmen Winpenny, Doris Daby, Samuel Pepper, Christine Adamson, Jamie Carungcong, Kribashnie Nundlall, Serge Fedele, Pardina Samson-Fessale, Alexandra Schoolmeesters, Laura Gomes de Almeida Martins, Rhian Bull, Patricia Correia Da Costa, Carina Bautista, Maria Eleanor Flores, Shameera Maheswaran, Lester Macabodbod, Rosalie Houseman, Marie-Louise Svensson, Amrinder Sayan, Carrie Fung, Justin Garner, Dilys Lai, Mark Nelson, Luke Moore, Shewta Gidwani, Gary Davies, Beatrice Ouma, Clovis Salinos, Jad Salha, Redasaad Yassein, Abdul Abbasi, Metod Oblak, Angelica Steward, Mini Thankachen, Amy Barker, Candida Fernandes, Veronica Beatriz, Leah Flores, Alfredo Soler-Carracedo, Alessandra Rocca, Shameera Maheswaran, Carmela Martella, Charlotte Lloyd, Ciara Nolan, Latoya Horsford, Laura Martins, Lervina Thomas, Mark Winstanley, Miriam Bourke, Nicholas Branch, Orhan Orhan, Richard Morton, Sangeetha Saunder, Shashank Patil, Stephen Hughes, Wu Zhe, Ashley De Leon, Ayaan Farah, Grace Rya, Katrin Alizadeh, Kirsty Leong, Laure Trepte, Nupur Goel, Patrick McGown, Ursula Kirwan, Tamiris Vilela Baião, Luana Marins, Sandro Nazer, Raquel Malaguthi de Souza, Marcella Feitosa, Flavia Lessa, Elizabeth Silva de Magalhães, Jamile Costenaro, Rita de Cassia Alves Lira, Ana Carolina, Andréa Cauduro de Castro, Andre Machado Da Silva, Dimas Kliemann, Rita De Cassia Alves Lira, Gemma Walker, Donna Norton, Vicki Lowthorpe, Monica Ivan, Patrick Lillie, Nicholas Easom, Juan Sierra Madero, Álvaro López Iñiguez, Guadalupe Patricia Muñuzuri Nájera, Claudia Paola Alarcón Murra, Audelia Alanis Vega, Teresa Muñoz Trejo, Olivia Pérez Rodríguez.LifeArc and CW+.Chelsea & Westminster NHS Foundation Trust. London, UK.Chelsea & Westminster NHS Foundation Trust. London, UK / Royal Brompton Hospital. Department of Respiratory Medicine. London, UK / Imperial College London. National Heart and Lung Institute. London, UK.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brazil.Imperial College London. National Heart and Lung Institute. London, UK.Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Mexico City, Mexico.Chelsea & Westminster NHS Foundation Trust, London. UK / Royal Brompton Hospital. Department of Respiratory Medicine. London, UK / Imperial College London. National Heart and Lung Institute. London, UK.Hospital Nossa Senhora da Conceição–Grupo Hospitalar Conceição. Departamento de Infectología. Porto Alegre, RS, Brazil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brazil.Royal Brompton Hospital. Department of Respiratory Medicine. London, UK / Imperial College London. National Heart and Lung Institute. London, UK.Chelsea & Westminster NHS Foundation Trust. London, UK / Royal Brompton Hospital. Department of Respiratory Medicine. London, UK / Imperial College London. National Heart and Lung Institute. London, UK.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brazil.Royal Brompton Hospital. Department of Respiratory Medicine. London, UK / Imperial College London. National Heart and Lung Institute. London, UK.Chelsea & Westminster NHS Foundation Trust. London, UK / Royal Brompton Hospital. Department of Respiratory Medicine. London, UK.Chelsea & Westminster NHS Foundation Trust. London, UK / Royal Brompton Hospital. Department of Respiratory Medicine. London, UK / Imperial College London. National Heart and Lung Institute. London, UK.Chelsea & Westminster NHS Foundation Trust. London, UK / Royal Brompton Hospital. Department of Respiratory Medicine. London, UK / Imperial College London. National Heart and Lung Institute. London, UK.Chelsea & Westminster NHS Foundation Trust. London, UK.Chelsea & Westminster NHS Foundation Trust. London, UK.Hull University Teaching Hospitals NHS Trust. Department of Infection. Hull, UK.Imperial College London. National Heart and Lung Institute. London, UK.Chelsea & Westminster NHS Foundation Trust. London, UK / Imperial College London. National Heart and Lung Institute. London, UK.Chelsea & Westminster NHS Foundation Trust. London, UK.Chelsea & Westminster NHS Foundation Trust. London, UK / London School of Hygiene and Tropical Medicine. Department of Clinical Research. London, UK.Chelsea & Westminster NHS Foundation Trust. London, UK.Background: COVID-19 has overwhelmed health services globally. Oral antiviral therapies are licensed worldwide, but indications and efficacy rates vary. We aimed to evaluate the safety and efficacy of oral favipiravir in patients hospitalised with COVID-19. Methods: We conducted a multicentre, open-label, randomised controlled trial of oral favipiravir in adult patients who were newly admitted to hospital with proven or suspected COVID-19 across five sites in the UK (n=2), Brazil (n=2) and Mexico (n=1). Using a permuted block design, eligible and consenting participants were randomly assigned (1:1) to receive oral favipiravir (1800 mg twice daily for 1 day; 800 mg twice daily for 9 days) plus standard care, or standard care alone. All caregivers and patients were aware of allocation and those analysing data were aware of the treatment groups. The prespecified primary outcome was the time from randomisation to recovery, censored at 28 days, which was assessed using an intention-to-treat approach. Post-hoc analyses were used to assess the efficacy of favipiravir in patients aged younger than 60 years, and in patients aged 60 years and older. The trial was registered with clinicaltrials.gov, NCT04373733. Findings: Between May 5, 2020 and May 26, 2021, we assessed 503 patients for eligibility, of whom 499 were randomly assigned to favipiravir and standard care (n=251) or standard care alone (n=248). There was no significant difference between those who received favipiravir and standard care, relative to those who received standard care alone in time to recovery in the overall study population (hazard ratio [HR] 1·06 [95% CI 0·89–1·27]; n=499; p=0·52). Post-hoc analyses showed a faster rate of recovery in patients younger than 60 years who received favipiravir and standard care versus those who had standard care alone (HR 1·35 [1·06–1·72]; n=247; p=0·01). 36 serious adverse events were observed in 27 (11%) of 251 patients administered favipiravir and standard care, and 33 events were observed in 27 (11%) of 248 patients receiving standard care alone, with infectious, respiratory, and cardiovascular events being the most numerous. There was no significant between-group difference in serious adverse events per patient (p=0·87). Interpretation: Favipiravir does not improve clinical outcomes in all patients admitted to hospital with COVID-19, however, patients younger than 60 years might have a beneficial clinical response. The indiscriminate use of favipiravir globally should be cautioned, and further high-quality studies of antiviral agents, and their potential treatment combinations, are warranted in COVID-19.engElsevierFavipiravir in patients hospitalised with COVID-19 (PIONEER trial): a multicentre, open-label, phase 3, randomised controlled trial of early intervention versus standard careinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleCOVID-19SARS-CoV-2FavipiravirOral antiviral therapiesPatients hospitalisedinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; 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dc.title.en_US.fl_str_mv |
Favipiravir in patients hospitalised with COVID-19 (PIONEER trial): a multicentre, open-label, phase 3, randomised controlled trial of early intervention versus standard care |
title |
Favipiravir in patients hospitalised with COVID-19 (PIONEER trial): a multicentre, open-label, phase 3, randomised controlled trial of early intervention versus standard care |
spellingShingle |
Favipiravir in patients hospitalised with COVID-19 (PIONEER trial): a multicentre, open-label, phase 3, randomised controlled trial of early intervention versus standard care Shah, Pallav L. COVID-19 SARS-CoV-2 Favipiravir Oral antiviral therapies Patients hospitalised |
title_short |
Favipiravir in patients hospitalised with COVID-19 (PIONEER trial): a multicentre, open-label, phase 3, randomised controlled trial of early intervention versus standard care |
title_full |
Favipiravir in patients hospitalised with COVID-19 (PIONEER trial): a multicentre, open-label, phase 3, randomised controlled trial of early intervention versus standard care |
title_fullStr |
Favipiravir in patients hospitalised with COVID-19 (PIONEER trial): a multicentre, open-label, phase 3, randomised controlled trial of early intervention versus standard care |
title_full_unstemmed |
Favipiravir in patients hospitalised with COVID-19 (PIONEER trial): a multicentre, open-label, phase 3, randomised controlled trial of early intervention versus standard care |
title_sort |
Favipiravir in patients hospitalised with COVID-19 (PIONEER trial): a multicentre, open-label, phase 3, randomised controlled trial of early intervention versus standard care |
author |
Shah, Pallav L. |
author_facet |
Shah, Pallav L. Orton, Christopher M. Grinsztejn, Beatriz Donaldson, Gavin C. Crabtree Ramírez, Brenda Tonkin, James Santos, Breno R. Cardoso, Sandra W. Ritchie, Andrew I. Conway, Francesca Riberio, Maria P. D. Wiseman, Dexter J. Tana, Anand Vijayakumar, Bavithra Caneja, Cielito Leaper, Craig Mann, Bobby Samson, Anda Bhavsar, Pankaj K. Boffito, Marta Johnson, Mark R. Pozniak, Anton Pelly, Michael |
author_role |
author |
author2 |
Orton, Christopher M. Grinsztejn, Beatriz Donaldson, Gavin C. Crabtree Ramírez, Brenda Tonkin, James Santos, Breno R. Cardoso, Sandra W. Ritchie, Andrew I. Conway, Francesca Riberio, Maria P. D. Wiseman, Dexter J. Tana, Anand Vijayakumar, Bavithra Caneja, Cielito Leaper, Craig Mann, Bobby Samson, Anda Bhavsar, Pankaj K. Boffito, Marta Johnson, Mark R. Pozniak, Anton Pelly, Michael |
author2_role |
author author author author author author author author author author author author author author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Shah, Pallav L. Orton, Christopher M. Grinsztejn, Beatriz Donaldson, Gavin C. Crabtree Ramírez, Brenda Tonkin, James Santos, Breno R. Cardoso, Sandra W. Ritchie, Andrew I. Conway, Francesca Riberio, Maria P. D. Wiseman, Dexter J. Tana, Anand Vijayakumar, Bavithra Caneja, Cielito Leaper, Craig Mann, Bobby Samson, Anda Bhavsar, Pankaj K. Boffito, Marta Johnson, Mark R. Pozniak, Anton Pelly, Michael |
dc.subject.en.en_US.fl_str_mv |
COVID-19 SARS-CoV-2 Favipiravir Oral antiviral therapies Patients hospitalised |
topic |
COVID-19 SARS-CoV-2 Favipiravir Oral antiviral therapies Patients hospitalised |
description |
The PIONEER trial group: Authors List - Damon Foster, Nadia Shabbir, Simon Connolly, Andrea Cartier, Sajjida Jaffer, Carmen Winpenny, Doris Daby, Samuel Pepper, Christine Adamson, Jamie Carungcong, Kribashnie Nundlall, Serge Fedele, Pardina Samson-Fessale, Alexandra Schoolmeesters, Laura Gomes de Almeida Martins, Rhian Bull, Patricia Correia Da Costa, Carina Bautista, Maria Eleanor Flores, Shameera Maheswaran, Lester Macabodbod, Rosalie Houseman, Marie-Louise Svensson, Amrinder Sayan, Carrie Fung, Justin Garner, Dilys Lai, Mark Nelson, Luke Moore, Shewta Gidwani, Gary Davies, Beatrice Ouma, Clovis Salinos, Jad Salha, Redasaad Yassein, Abdul Abbasi, Metod Oblak, Angelica Steward, Mini Thankachen, Amy Barker, Candida Fernandes, Veronica Beatriz, Leah Flores, Alfredo Soler-Carracedo, Alessandra Rocca, Shameera Maheswaran, Carmela Martella, Charlotte Lloyd, Ciara Nolan, Latoya Horsford, Laura Martins, Lervina Thomas, Mark Winstanley, Miriam Bourke, Nicholas Branch, Orhan Orhan, Richard Morton, Sangeetha Saunder, Shashank Patil, Stephen Hughes, Wu Zhe, Ashley De Leon, Ayaan Farah, Grace Rya, Katrin Alizadeh, Kirsty Leong, Laure Trepte, Nupur Goel, Patrick McGown, Ursula Kirwan, Tamiris Vilela Baião, Luana Marins, Sandro Nazer, Raquel Malaguthi de Souza, Marcella Feitosa, Flavia Lessa, Elizabeth Silva de Magalhães, Jamile Costenaro, Rita de Cassia Alves Lira, Ana Carolina, Andréa Cauduro de Castro, Andre Machado Da Silva, Dimas Kliemann, Rita De Cassia Alves Lira, Gemma Walker, Donna Norton, Vicki Lowthorpe, Monica Ivan, Patrick Lillie, Nicholas Easom, Juan Sierra Madero, Álvaro López Iñiguez, Guadalupe Patricia Muñuzuri Nájera, Claudia Paola Alarcón Murra, Audelia Alanis Vega, Teresa Muñoz Trejo, Olivia Pérez Rodríguez. |
publishDate |
2022 |
dc.date.issued.fl_str_mv |
2022 |
dc.date.accessioned.fl_str_mv |
2023-04-14T14:00:40Z |
dc.date.available.fl_str_mv |
2023-04-14T14:00:40Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
SHAH, Pallav L. et al. Favipiravir in patients hospitalised with COVID-19 (PIONEER trial): a multicentre, open-label, phase 3, randomised controlled trial of early intervention versus standard care. The Lancet Respiratory Medicine, p. 1-10, Dec. 14, 2022. |
dc.identifier.uri.fl_str_mv |
https://www.arca.fiocruz.br/handle/icict/57785 |
dc.identifier.issn.en_US.fl_str_mv |
0140-6736 |
dc.identifier.doi.none.fl_str_mv |
10.1016/S2213-2600(22)00412-X |
identifier_str_mv |
SHAH, Pallav L. et al. Favipiravir in patients hospitalised with COVID-19 (PIONEER trial): a multicentre, open-label, phase 3, randomised controlled trial of early intervention versus standard care. The Lancet Respiratory Medicine, p. 1-10, Dec. 14, 2022. 0140-6736 10.1016/S2213-2600(22)00412-X |
url |
https://www.arca.fiocruz.br/handle/icict/57785 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.publisher.none.fl_str_mv |
Elsevier |
publisher.none.fl_str_mv |
Elsevier |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da FIOCRUZ (ARCA) instname:Fundação Oswaldo Cruz (FIOCRUZ) instacron:FIOCRUZ |
instname_str |
Fundação Oswaldo Cruz (FIOCRUZ) |
instacron_str |
FIOCRUZ |
institution |
FIOCRUZ |
reponame_str |
Repositório Institucional da FIOCRUZ (ARCA) |
collection |
Repositório Institucional da FIOCRUZ (ARCA) |
bitstream.url.fl_str_mv |
https://www.arca.fiocruz.br/bitstream/icict/57785/1/license.txt https://www.arca.fiocruz.br/bitstream/icict/57785/2/ve_Shah_Pallav_etal_INI_2022.pdf |
bitstream.checksum.fl_str_mv |
5a560609d32a3863062d77ff32785d58 1517c3321c7b9ebf7e0dd8c1d993e47a |
bitstream.checksumAlgorithm.fl_str_mv |
MD5 MD5 |
repository.name.fl_str_mv |
Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ) |
repository.mail.fl_str_mv |
repositorio.arca@fiocruz.br |
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1813008923921219584 |