Potential role for nitazoxanide in treating SARS-CoV-2 infection

Martins-Filho, Paulo Ricardo; Barreto-Alves, José Antônio; Fakhouri, Ricardo

doi:10.1152/ajplung.00170.2020

Cited by 21 publications

(28 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Number of clinical trials registered using nitazoxanide as the only drug or in combination with other antivirals further substantiates the hypothesis on the high promise of nitazoxanide ( Mahmoud et al, 2020 ; Martins-Filho et al, 2020 ). A total of 19 new clinical trials for COVID-19, have been registered in the USA, Egypt, Mexico, Argentina, Nigeria and Brazil in the past five months, between April to August 2020 ( https://clinicaltrials.gov/ ) (Nitazoxanide clinical trials, 2020).…”

Section: Clinical Trials Of Nitazoxanide Against Covid-19mentioning

confidence: 71%

“…The nitrothiazole moiety exhibits antiprotozoal, antiproliferative, antiinfective effect ( Colín-Lozano et al, 2017 ), control oxidative stress ( El-Kowrany et al, 2019 ) and disrupts pyruvate: ferredoxin oxidoreductase dependent redox reactions essential for anaerobic protozoa and bacteria for their energy metabolism and survival ( Hemphill et al, 2006 ; Kumar et al, 2014 ; Rossignol, 2009 ). Thus it can be postulated that nitazoxanide can inhibit various stages of the virus multiplication cycle and also potentiate host innate immunity ( Martins-Filho et al, 2020 ; Padmanabhan, 2020 ). Furthermore, the potential of nitazoxanide to enhance natural host antiviral mechanisms, suggests lower possibility of developing antiviral resistance in comparison with drugs directly acting only on viral proteins ( Krátký and Vinšová, 2011 ; Tilmanis et al, 2020 ).…”

Section: Nitazoxanidementioning

confidence: 99%

“…TIZ treatment reduced inflammation in macrophage cell lines by suppressing NF-κB, MAPK and PI3K/Akt/mTOR pathway ( Shou et al, 2019 ), whereas in case of LPS induced inflammatory microglia, TIZ treatment decreased the release of pro-inflammatory cytokines including TNF-α, IL-1β, IL-6, chemokines like CCL-2 and CCL-3, intrinsic nitric oxide synthase (iNOS) and cyclooxygenase2 (COX2) expression (X. W. Li et al, 2020 ; Trabattoni et al, 2016 ). Thus in the case of COVID-19 patients, nitazoxanide could serve as a potential candidate, curbing the inflammation and activating host innate immune responses crucial for addressing SARS-CoV-2 pathogenesis ( Martins-Filho et al, 2020 ).…”

Section: Nitazoxanidementioning

confidence: 99%

“…Nitazoxanide high dose of 1 g two times daily administered in AIDS patients suffering from diarrhoea, devoid of any severe side effects ( Fox and Saravolatz, 2005 ; Jr, 2004 ). Thus nitazoxanide is effective and safe therapeutic intervention and its estimated generic pricing is $1.41 for a 14-day COVID-19 treatment at 500 mg twice daily dose ( Mahmoud et al, 2020 ; Martins-Filho et al, 2020 ; Pepperrell et al, 2020 ), which makes therapy inexpensive.…”

Section: Nitazoxanide Dosing and Safetymentioning

confidence: 99%

“…Furthermore, clinical trials suggested the potential role of nitazoxanide in gastroenteritis, hepatitis and influenza ( Rossignol, 2014 ). A significant finding is the ability of nitazoxanide to promote balance between pro-inflammatory and anti-inflammatory responses in humans, which could play a crucial role in COVID-19 by curbing the hyperinflammatory cytokine storm ( Jasenosky et al, 2019 ; Martins-Filho et al, 2020 ; Rossignol, 2016 ; Shakya et al, 2018a ). Repurposing nitazoxanide against COVID-19 has been suggested in many reports ( Alonso and Farina, 2020 ; Arshad et al, 2020 ; Bobrowski et al, 2020 ; Chibber et al, 2020 ; Mahmoud et al, 2020 ; Martins-Filho et al, 2020 ; Padmanabhan, 2020 ; Padmanabhan and Padmanabhan, 2020 ; Pepperrell et al, 2020 ; Rajoli et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

A review on possible mechanistic insights of Nitazoxanide for repurposing in COVID-19

Lokhande

Devarajan

2021

European Journal of Pharmacology

View full text Add to dashboard Cite

Section: Clinical Trials Of Nitazoxanide Against Covid-19mentioning

confidence: 71%

Section: Nitazoxanidementioning

confidence: 99%

Section: Nitazoxanidementioning

confidence: 99%

Section: Nitazoxanide Dosing and Safetymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

A review on possible mechanistic insights of Nitazoxanide for repurposing in COVID-19

Lokhande

Devarajan

2021

European Journal of Pharmacology

View full text Add to dashboard Cite

Efficacy and safety of nitazoxanide in treating SARS-CoV-2 infection: a systematic review and meta-analysis of blinded, placebo-controlled, randomized clinical trials

Martins-Filho

Nascimento-Júnior

Barreto-Alves

et al. 2022

Eur J Clin Pharmacol

Self Cite

View full text Add to dashboard Cite

Purpose Nitazoxanide is a broad-spectrum antiparasitic that has been tested for COVID-19 due to its anti-inflammatory effects and in vitro antiviral activity. This study synthesized the best evidence on the efficacy and safety of nitazoxanide in COVID-19. Methods Searches for studies were performed in peer-reviewed and grey-literature from January 1, 2020 to May 23, 2022. The following elements were used to define eligibility criteria: (1) Population: individuals with COVID-19; (2) Intervention: nitazoxanide; (3) Comparison: placebo; (4) Outcomes: primary outcome was death, and secondary outcomes were viral load, positive RT-PCR status, serum biomarkers of inflammation, composite measure of disease progression (ICU admission or invasive mechanical ventilation), and any adverse events; (5) Study type: blinded, placebo-controlled, randomized clinical trials (RCTs). Treatment effects were reported as relative risk (RR) for dichotomous variables and standardized mean difference (SMD) for continuous variables with 95% confidence intervals (CI). Results Five blinded, placebo-controlled RCTs were included and enrolled individuals with mild or moderate SARS-CoV-2 infection. We found no difference between nitazoxanide and placebo in reducing viral load (SMD = − 0.16; 95% CI − 0.38 to 0.05) and the frequency of positive RTP-PCR results (RR = 0.92; 95% CI 0.81 to 1.06). In addition, there was no decreased risk for disease progression (RR = 0.63; 95% CI 0.38 to 1.04) and death (RR = 0.81; 95% CI 0.36 to 1.78) among patients receiving nitazoxanide. Patients with COVID-19 treated with nitazoxanide had decreased levels of white blood cells (SMD = − 0.15; 95% − 0.29 to − 0.02), lactate dehydrogenase (LDH) (SMD − 0.32; 95% − 0.52 to − 0.13), and D-dimer (SMD − 0.49; 95% CI − 0.68 to − 0.31) compared to placebo, but the magnitude of effect was considered small to moderate. Conclusion This systematic review showed no evidence of clinical benefits of the use of nitazoxanide to treat patients with mild or moderate COVID-19. In addition, we found a reduction in WBC, LDH, and D-dimer levels among nitazoxanide-treated patients, but the effect size was considered small to moderate. Supplementary Information The online version contains supplementary material available at 10.1007/s00228-022-03380-5.

show abstract

Investigational antiviral drugs for the treatment of COVID-19 patients

et al. 2022

View full text Add to dashboard Cite

In the current pandemic of coronavirus disease 2019 (COVID-19), antiviral drugs are at the center of attention because of their critical role against severe acute respiratory disease syndrome coronavirus 2 (SARS-CoV-2). In addition to designing new antivirals against SARS-COV-2, a drug repurposing strategy is a practical approach for treating COVID-19. A brief insight about antivirals would help clinicians to choose the best medication for the treatment of COVID-19. In this review, we discuss both novel and repurposed investigational antivirals, focusing on in vitro, in vivo, and clinical trial studies.

show abstract

Potential role for nitazoxanide in treating SARS-CoV-2 infection

Cited by 21 publications

References 7 publications

A review on possible mechanistic insights of Nitazoxanide for repurposing in COVID-19

A review on possible mechanistic insights of Nitazoxanide for repurposing in COVID-19

Efficacy and safety of nitazoxanide in treating SARS-CoV-2 infection: a systematic review and meta-analysis of blinded, placebo-controlled, randomized clinical trials

Investigational antiviral drugs for the treatment of COVID-19 patients

Contact Info

Product

Resources

About