Although early intervention with favipiravir did not improve clinical outcomes for the overall population of hospitalised patients with COVID-19, a phase 3 study displayed that the agent may induce health benefits for patients under 60 years of age.
“Re-using existing agents for a different purpose is faster than developing novel drugs,” argued Dr Christopher Orton (Royal Brompton Hospital, UK) . Following this rationale, the phase 3 PIONEER trial (NCT04373733) was designed to test favipiravir, a medicine that demonstrated activity against various RNA viruses in individuals with COVID-19 (n=503). Patients who were hospitalised due to COVID-19 were randomised 1:1 to receive a 10-day treatment with favipiravir or placebo. The primary objective of the trial was to assess whether early intervention with favipiravir reduced the time to significant improvement in the health status of the participants. For this purpose, a 7-category ordinal scale was used, ranging from 1 ‘not hospitalised with resumption of normal activities’ to 7 ‘death’.
The intervention was not significantly different from placebo when the whole study population was investigated (P=0.73). However, the favipiravir arm was superior to the placebo arm in participants under 60 years of age (P=0.03). Similarly, secondary outcomes demonstrated that participants under 60 benefitted from favipiravir versus placebo in terms of ‘mechanical ventilation-free survival’ (P=0.02).
Dr Orton added that these results implicate that a wider evaluation of anti-viral medications, including their age-stratified effects, should be considered in patients who are hospitalised with COVID-19.
- Orton CM, et al. A randomised controlled trial of early intervention with oral favipiravir in patients hospitalised with COVID-19 (PIONEER Trial). ALERT 3, RCT2882, ERS International Congress 2022, Barcelona, Spain, 4–6 September.
Copyright ©2022 Medicom Medical Publishers
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Table of Contents: ERS 2022
Letter from the Editor
ERS 2022 Highlights Podcast
COVID-19: What Is New?
Does vilobelimab reduce mortality in severe COVID-19?
Awake proning not positive in COVID-19
Favipiravir may help patients over 60 years with COVID-19 to recover
Brensocatib fails in severe COVID-19
Inhaled agent under investigation for COVID-19
Accurate voice-based COVID-19 diagnostic test in development
Novel scoring tool for post-COVID syndrome aids clinicians and researchers
COPD: Therapies and Innovations
Icenticaftor achieves results on top of triple inhalation therapy in COPD
STARR2: A new approach for treating COPD exacerbations
COPD medication not effective in symptomatic smokers with preserved spirometry
Do digital tools improve physical activity in COPD?
Hyperpolarised gas MRI ready for clinical use
All About Asthma
Tezepelumab in asthma: mucus plugging down, lung function up
Digital asthma intervention improves health and reduces costs
Digitally enhanced therapy lowers treatment burden and costs in severe asthma
Mepolizumab beneficial for patients with severe eosinophilic asthma
Progress in Paediatrics
Antibiotics cause increased risk of wheezing in severe RSV bronchiolitis
Inhaled corticosteroids useful in preterms with decreased lung function
Fish oil or vitamin D during pregnancy can prevent croup
Encouraging results of nintedanib in children with fibrosing ILD
Focus on Interventional Pulmonology
Head-to-head: lung volume reduction surgery vs endobronchial valves
Durable effect of endobronchial valves in severe emphysema
Cone beam CT-guided ENB improves detection of pulmonary nodules
Confirmatory mediastinoscopy not needed in resectable NSCLC
Sleep and Breathing Disorders
In the spotlight: Cancer trends in obstructive sleep apnoea
Impact of CPAP on cardiac endpoints in OSA
Sustained hypoxaemia predicts unprovoked VTE in OSA
CPAP therapy in the prevention of cardiovascular risk in patients with OSA
Other Remarkable Research
Excellent results for high-flow nasal cannula oxygen therapy in acute respiratory failure
Antifibrotic therapy may slow down FVC decline in RAILD
Intravenous N-acetylcysteine performs well in hospitalised patients
Men and women respond differently to diesel exhaust
New trends in cystic lung diseases
Hydrocortisone does not help preterm infants