1/
🔥EXCELLENT results for Phase III multicentric double-blind RCT of #proxalutamide for hospitalized #COVID_19 patients🔥
n=588
Study led by @FlavioCadegiani in 🇧🇷
92% reduction in mortality ! prnewswire.com/news-releases/…
2/
Keep in mind that this is a press release, not a scientific publication.
A point is particularly unclear in the press release, i.e. authors claim 588 patients were enrolled, but then later write they were 294 in proxalutamide group & 296 in control group.
294+296=590≠588.
3/
Detailed results were shared in Portuguese during this press conference in 🇧🇷
4/
These Phase III data are the best results seen hitherto among hospitalized COVID-19 patients. They confirm the excellent Phase II results published earlier by the same group of investigators
5/
#Proxalutamide is a novel #androgen-receptor antagonist, initially developed for prostate cancer.
Androgen-receptor antagonists are postulated to downregulate #TMPRSS2. They include registered drugs like bicalutamide.
6/
Other classes of drugs targeting TMPRSS2 should be further investigated for treatment of COVID-19. This strategy has been way too neglected...😧
My personal preference goes for #bromhexine, a cheap, safe per os mucolytic.
7/
If peer-review confirms these results, then #proxalutamide will become standard of care for #COVID_19 in hospitals. I'm curious to hear what Kintor, the small biotech in 🇨🇳 that owns patents for proxalutamide, plans to do to make it available worldwide. en.kintor.com.cn
8/
In sum:
▶️#Proxalutamide may well be the game-changer for hospitalized C19 patients. Awaiting peer review though.
▶️There are other (more acessible) anti-androgens, as well as other 💊 targeting TMPRSS2. RCTs urgently needed.
▶️Awaiting Kintor's access plan for proxalutamide.

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More from @julienpotet

10 Mar
1/
Excellent results for phase 3 placebo-controlled RCT in 🇺🇸 among mild-to-moderate #COVID_19 patients at high risk of clinical deterioration.
Cocktail of 700mg of #bamlanivimab & 1,400mg of #etesevimab reduced risk of hospitalizations & death by 87%.
2/
This press release needs to be taken with grain of salt. Among other limitations, it says nothing about different variants of concern.
3/
Concern now is that bamlanivimab is quite accessible in monotherapy, but not yet in combination w/ etesevimab.
In Oct 2020, @gatesfoundation signed a contract w/ Lilly & Fujifilm to manufacture more bamlanivimab. Could it now also include etesevimab?
Read 6 tweets
12 Feb
1/
Large RCT (n=930) in Barcelona, 🇪🇸: #calcifediol vs control among hospitalized #COVID_19 patients.
Strong clinical benefit: ↘️ICU admission & ↘️mortality.
Unclear to me why this preprint got unnoticed (published three weeks ago) !
#VitaminD
papers.ssrn.com/sol3/papers.cf…
2/
These new results confirm similar positive results for calcifediol generated in Cordoba in a smaller pilot RCT
3/
The new study in Barcelona has limitations: no placebo (open label); randomization per ward (not individual); modified intention to treat for some patients.
Yet results are very encouraging !
It was apparently submitted to @TheLancet. I hope it will get published soon.
Read 6 tweets
11 Feb
Live-tweeting about the 1st online conference on noma disease. Stay tune !
#ZeroNoma #NTDs
Opening message by @PeterHotez. Peter is among other things editor of @PLOSNTDs. The journal recently agreed to include noma in the list of eligible diseases for publication. #NTDs
Noma survivor @FidelStrub tells his personal story. Underwent 27 surgical operations ! Moving testimony by a strong advocate !
Read 18 tweets
11 Jan
Bangladesh: large RCT (n=606) of #mouthwash, gargling, nasal spraying & eye drops w/ 1% povidone-iodine (PVP-I, aka #Betadine) for #COVID_19. Every 4 hours for 4 weeks.
Impressive results.
bioresearchcommunications.com/index.php/brc/…
h/t @Covid19Crusher
Mouthwash solutions of PVP-I can be easily purchased OTC in many countries. Nasal sprays and eye drops are less easily accessible (i.e. not available OTC in France).
There have been other in vivo and in vitro studies over the last months. A tiny RCT from Singapore had previously found encouraging results.
Read 5 tweets
7 Dec 20
1/
There have been several small RCTs over the last weeks suggesting a clinical benefit for #ivermectin for #COVID_19.

It’s time for a MEGA THREAD on ivermectin, aka the “wonder drug”!

Let's start the show !🔥🔥🔥
2/
Ivermectin belongs to the family of avermectins, which are natural fermentation products of soil bacteria. A Nobel Prize of Medicine was awarded for their discovery. Image
3/
Ivermectin is indicated for several parasitic infections: onchocerciasis, lymphatic filariasis, strongyloidiasis, scabies. It works on head lice too. #NTDs

But ivermectin may have a broader therapeutic benefit. Hence its nickname, the “wonder drug”.
pubmed.ncbi.nlm.nih.gov/28196978/
Read 20 tweets
19 Apr 20
1/
In this thread, I’ll speak about #tocilizumab and challenges to access it. Tocilizumab is an anti-IL-6-receptor monoclonal antibody. It is a promising investigational drug to treat the cytokine storm associated with severe #COVID19.
2/
The cytokine storm (aka cytokine release syndrome) occurs when a high number of white blood cells are activated and release inflammatory cytokines, such as IL-6, which in turn activate more white blood cells.
3/
Tocilizumab is not an antiviral agent. Like other host focused therapies for COVID19, tocilizumab can be used in association with an effective antiviral and their combined actions may be complementary.
Read 22 tweets

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