TY - JOUR
T1 - Azithromycin for treatment of hospitalised COVID-19 patients: a randomised, multicentre, open-label clinical trial (DAWn-AZITHRO)
AU - Gyselinck, Iwein
AU - Liesenborghs, Laurens
AU - Belmans, Ann
AU - Engelen, Matthias M
AU - Betrains, Albrecht
AU - Van Thillo, Quentin
AU - Nguyen, Pham Anh Hong
AU - Goeminne, Pieter
AU - Soenen, Ann-Catherine
AU - De Maeyer, Nikolaas
AU - Pilette, Charles
AU - Papleux, Emmanuelle
AU - Vanderhelst, Eef
AU - Derweduwen, Aurélie
AU - Alexander, Patrick
AU - Bouckaert, Bernard
AU - Martinot, Jean-Benoît
AU - Decoster, Lynn
AU - Vandeurzen, Kurt
AU - Schildermans, Rob
AU - Verhamme, Peter
AU - Janssens, Wim
AU - Vos, Robin
N1 - FTX; (CC BY-NC 4.0)
PY - 2022
Y1 - 2022
N2 - Background and objectives: Azithromycin was rapidly adopted as a repurposed drug to treat coronavirus disease 2019 (COVID-19) early in the pandemic. We aimed to evaluate its efficacy in patients hospitalised for COVID-19.Methods: In a series of randomised, open-label, phase 2 proof-of-concept, multicentre clinical trials (Direct Antivirals Working against the novel coronavirus (DAWn)), several treatments were compared with standard of care. In 15 Belgian hospitals, patients hospitalised with moderate to severe COVID-19 were allocated 2:1 to receive standard of care plus azithromycin or standard of care alone. The primary outcome was time to live discharge or sustained clinical improvement, defined as a two-point improvement on the World Health Organization (WHO) ordinal scale sustained for at least 3 days.Results: Patients were included between April 22 and December 17, 2020. When 15-day follow-up data were available for 160 patients (56% of preset cohort), an interim analysis was performed at request of the independent Data Safety and Monitoring Board. Subsequently, DAWn-AZITHRO was stopped for futility. In total, 121 patients were allocated to the treatment arm and 64 patients to the standard-of-care arm. We found no effect of azithromycin on the primary outcome with a hazard ratio of 1.044 (95% CI 0.772-1.413; p=0.7798). None of the predefined subgroups showed significant interaction as covariates in the Fine-Gray regression analysis. No benefit of azithromycin was found on any of the short- and longer-term secondary outcomes.Conclusion: Time to clinical improvement is not influenced by azithromycin in patients hospitalised with moderate to severe COVID-19.
AB - Background and objectives: Azithromycin was rapidly adopted as a repurposed drug to treat coronavirus disease 2019 (COVID-19) early in the pandemic. We aimed to evaluate its efficacy in patients hospitalised for COVID-19.Methods: In a series of randomised, open-label, phase 2 proof-of-concept, multicentre clinical trials (Direct Antivirals Working against the novel coronavirus (DAWn)), several treatments were compared with standard of care. In 15 Belgian hospitals, patients hospitalised with moderate to severe COVID-19 were allocated 2:1 to receive standard of care plus azithromycin or standard of care alone. The primary outcome was time to live discharge or sustained clinical improvement, defined as a two-point improvement on the World Health Organization (WHO) ordinal scale sustained for at least 3 days.Results: Patients were included between April 22 and December 17, 2020. When 15-day follow-up data were available for 160 patients (56% of preset cohort), an interim analysis was performed at request of the independent Data Safety and Monitoring Board. Subsequently, DAWn-AZITHRO was stopped for futility. In total, 121 patients were allocated to the treatment arm and 64 patients to the standard-of-care arm. We found no effect of azithromycin on the primary outcome with a hazard ratio of 1.044 (95% CI 0.772-1.413; p=0.7798). None of the predefined subgroups showed significant interaction as covariates in the Fine-Gray regression analysis. No benefit of azithromycin was found on any of the short- and longer-term secondary outcomes.Conclusion: Time to clinical improvement is not influenced by azithromycin in patients hospitalised with moderate to severe COVID-19.
U2 - 10.1183/23120541.00610-2021
DO - 10.1183/23120541.00610-2021
M3 - A1: Web of Science-article
C2 - 35233389
SN - 2312-0541
VL - 8
JO - ERJ Open Research
JF - ERJ Open Research
IS - 1
M1 - 00610-2021
ER -