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.

Abstract

BACKGROUND:

This study investigated the clinical outcomes, virological efficacy and safety of nitazoxanide in the treatment of patients with COVID-19.

RESEARCH DESIGN AND METHODS:

The PubMed, Embase, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov databases were searched for relevant articles written before August 23, 2022. Only randomized controlled trials (RCTs) that assessed the usefulness and safety of nitazoxanide in patients with COVID-19 were included.

RESULTS:

Five RCTs were included. The overall mortality of COVID-19 patients receiving nitazoxanide (study group) was 1.3% (9/670), which was lower than the control group (1.8%, 12/681), but this difference did not reach statistical significance (risk difference [RD], 0.00; 95% CI: -0.01 to 0.01; P =0.97). However, nitazoxanide was associated with a higher virological eradication rate than placebo or standard care (RD, 0.09; 95% CI: 0.01 to 0.17; P = 0.03). Compared with the placebo or standard care, nitazoxanide were associated with a similar risk of any adverse event (RD, -0.02; 95% CI: -0.07 to 0.03; P = 0.44).

CONCLUSIONS:

Although nitazoxanide can help virological eradication and is also tolerable, it does not provide additional clinical benefits. Based on these evidences, the use of nitazoxanide in the treatment of patients with COVID-19 is not recommended.

• Authors: Tzu-Chieh Weng, Teng-Song Weng, Chih-Cheng Lai, Chien-Ming Chao, Jui-Hsiang Wang
• Journal: Expert review of anti-infective therapy (Expert Rev Anti Infect Ther) Vol. 20 Issue 12 Pg. 1615-1622 (12 2022) ISSN: 1744-8336 [Electronic] England
• PMID: 36317748 (Publication Type: Meta-Analysis, Systematic Review, Journal Article)

Chemical References

• nitazoxanide
• Nitro Compounds
• Thiazoles

Topics

• Humans
• Randomized Controlled Trials as Topic
• Nitro Compounds (adverse effects)
• Thiazoles (adverse effects)
• COVID-19 Drug Treatment