A Randomized, Double-Blind, Multicenter Clinical Study Comparing the Efficacy and Safety of a Drug Combination of Lopinavir/Ritonavir-Azithromycin, Lopinavir/Ritonavir-Doxycycline, and Azithromycin-Hydroxychloroquine for Patients Diagnosed with Mild to Moderate COVID-19 Infections

Background. At the present time, COVID-19 vaccines are at the testing stage, and an effective treatment for COVID-19 incorporating appropriate safety measures remains the most significant obstacle to be overcome. A strategic countermeasure is, therefore, urgently required. Aim. This study aims to ev...

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Main Authors: Purwati, -, Budiono, -, Brian Eka Rachman, -, Yulistiani, -, Andang Miatmoko, -, Nasronudin, -, Soroy Lardo, -, Yongki Iswandi Purnama, -, Mafidhatul Laely, -, Ike Rochmad, -, Taufik Ismail, -, Sri Wulandari, -, Dwi Setyawan, -, Alfian Nur Rosyid, -, Herley Windo Setiawan, -, Prastuti Asta Wulaningrum, -, Tri Pudy Asmarawati, -, Erika Marfiani, -, Shinta Karina Yuniati, -, Muhammad Rabiul Fuadi, -, Pepy Dwi Endraswari, -, Purwaningsih, -, Eryk Hendrianto, -, Deya Karsari, -, Aristika Dinaryanti, -, Nora Ertanti, -, Igo Syaiful Ihsan, -, Disca Sandyakala Purnama, -, Yuni Indrayani, -
Format: Article PeerReviewed
Language:English
English
English
Published: Hindawi 2021
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Online Access:https://repository.unair.ac.id/123735/2/C-21%20Artikel.pdf
https://repository.unair.ac.id/123735/1/C-21%20Kualitas%20Karil.pdf
https://repository.unair.ac.id/123735/3/C-21%20Similarity.pdf
https://repository.unair.ac.id/123735/
https://www.hindawi.com/journals/bri/2021/6685921/
https://doi.org/10.1155/2021/6685921
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Institution: Universitas Airlangga
Language: English
English
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id id-langga.123735
record_format dspace
institution Universitas Airlangga
building Universitas Airlangga Library
continent Asia
country Indonesia
Indonesia
content_provider Universitas Airlangga Library
collection UNAIR Repository
language English
English
English
topic R Medicine
RS Pharmacy and materia medica
RS1-441 Pharmacy and materia medica
RS200-201 Pharmaceutical dosage forms
spellingShingle R Medicine
RS Pharmacy and materia medica
RS1-441 Pharmacy and materia medica
RS200-201 Pharmaceutical dosage forms
Purwati, -
Budiono, -
Brian Eka Rachman, -
Yulistiani, -
Andang Miatmoko, -
Nasronudin, -
Soroy Lardo, -
Yongki Iswandi Purnama, -
Mafidhatul Laely, -
Ike Rochmad, -
Taufik Ismail, -
Sri Wulandari, -
Dwi Setyawan, -
Alfian Nur Rosyid, -
Herley Windo Setiawan, -
Prastuti Asta Wulaningrum, -
Tri Pudy Asmarawati, -
Erika Marfiani, -
Shinta Karina Yuniati, -
Muhammad Rabiul Fuadi, -
Pepy Dwi Endraswari, -
Purwaningsih, -
Eryk Hendrianto, -
Deya Karsari, -
Aristika Dinaryanti, -
Nora Ertanti, -
Igo Syaiful Ihsan, -
Disca Sandyakala Purnama, -
Yuni Indrayani, -
A Randomized, Double-Blind, Multicenter Clinical Study Comparing the Efficacy and Safety of a Drug Combination of Lopinavir/Ritonavir-Azithromycin, Lopinavir/Ritonavir-Doxycycline, and Azithromycin-Hydroxychloroquine for Patients Diagnosed with Mild to Moderate COVID-19 Infections
description Background. At the present time, COVID-19 vaccines are at the testing stage, and an effective treatment for COVID-19 incorporating appropriate safety measures remains the most significant obstacle to be overcome. A strategic countermeasure is, therefore, urgently required. Aim. This study aims to evaluate the efficacy and safety of a combination of lopinavir/ritonavir-azithromycin, lopinavir/ritonavir-doxycycline, and azithromycin-hydroxychloroquine used to treat patients with mild to moderate COVID-19 infections. Setting and Design. This study was conducted at four different clinical study sites in Indonesia. The subjects gave informed consent for their participation and were confirmed as being COVID-19-positive by means of an RT-PCR test. The present study constituted a randomized, double-blind, and multicenter clinical study of patients diagnosed with mild to moderate COVID-19 infection. Materials and Methods. Six treatment groups participated in this study: a Control group administered with a 500 mg dose of azithromycin; Group A which received a 200/50 mg dose of lopinavir/ritonavir and 500 mg of azithromycin; Group B treated with a 200/50 mg dose of lopinavir/ritonavir and 200 mg of doxycycline; Group C administered with 200 mg of hydroxychloroquine and 500 mg of azithromycin; Group D which received a 400/100 mg dose of lopinavir/ritonavir and 500 mg of azithromycin; and Group E treated with a 400/100 mg dose of lopinavir/ritonavir and 200 mg of doxycycline. Results. 754 subjects participated in this study: 694 patients (92.4%) who presented mild symptoms and 57 patients (7.6%) classified as suffering from a moderate case of COVID-19. On the third day after treatment, 91.7%–99.2% of the subjects in Groups A–E were confirmed negative by a PCR swab test compared to 26.9% in the Control group. Observation of all groups which experienced a significant decrease in virus load between day 1 and day 7 was undertaken. Other markers, such as CRP and IL-6, were significantly lower in all treatment groups ( and ) than in the Control group. Furthermore, IL-10 and TNF-α levels were significantly elevated in all treatment groups (). The administration of azithromycin to the Control group increased CRP and IL-6 levels, while reduced IL-10 and TNF-α on day 7 () compared with day 1. Decreases in ALT and AST levels were observed in all groups (). There was an increase in creatinine in the serum level of the Control, C, D, and E groups (), whereas the BUN level was elevated in all groups (). Conclusions. The study findings suggest that the administration of lopinavir/ritonavir-doxycycline, lopinavir/ritonavir-azithromycin, and azithromycin-hydroxychloroquine as a dual drug combination produced a significantly rapid PCR conversion rate to negative in three-day treatment of mild to moderate COVID-19 cases. Further studies should involve observation of older patients with severe clinical symptoms in order to collate significant amounts of demographic data.
format Article
PeerReviewed
author Purwati, -
Budiono, -
Brian Eka Rachman, -
Yulistiani, -
Andang Miatmoko, -
Nasronudin, -
Soroy Lardo, -
Yongki Iswandi Purnama, -
Mafidhatul Laely, -
Ike Rochmad, -
Taufik Ismail, -
Sri Wulandari, -
Dwi Setyawan, -
Alfian Nur Rosyid, -
Herley Windo Setiawan, -
Prastuti Asta Wulaningrum, -
Tri Pudy Asmarawati, -
Erika Marfiani, -
Shinta Karina Yuniati, -
Muhammad Rabiul Fuadi, -
Pepy Dwi Endraswari, -
Purwaningsih, -
Eryk Hendrianto, -
Deya Karsari, -
Aristika Dinaryanti, -
Nora Ertanti, -
Igo Syaiful Ihsan, -
Disca Sandyakala Purnama, -
Yuni Indrayani, -
author_facet Purwati, -
Budiono, -
Brian Eka Rachman, -
Yulistiani, -
Andang Miatmoko, -
Nasronudin, -
Soroy Lardo, -
Yongki Iswandi Purnama, -
Mafidhatul Laely, -
Ike Rochmad, -
Taufik Ismail, -
Sri Wulandari, -
Dwi Setyawan, -
Alfian Nur Rosyid, -
Herley Windo Setiawan, -
Prastuti Asta Wulaningrum, -
Tri Pudy Asmarawati, -
Erika Marfiani, -
Shinta Karina Yuniati, -
Muhammad Rabiul Fuadi, -
Pepy Dwi Endraswari, -
Purwaningsih, -
Eryk Hendrianto, -
Deya Karsari, -
Aristika Dinaryanti, -
Nora Ertanti, -
Igo Syaiful Ihsan, -
Disca Sandyakala Purnama, -
Yuni Indrayani, -
author_sort Purwati, -
title A Randomized, Double-Blind, Multicenter Clinical Study Comparing the Efficacy and Safety of a Drug Combination of Lopinavir/Ritonavir-Azithromycin, Lopinavir/Ritonavir-Doxycycline, and Azithromycin-Hydroxychloroquine for Patients Diagnosed with Mild to Moderate COVID-19 Infections
title_short A Randomized, Double-Blind, Multicenter Clinical Study Comparing the Efficacy and Safety of a Drug Combination of Lopinavir/Ritonavir-Azithromycin, Lopinavir/Ritonavir-Doxycycline, and Azithromycin-Hydroxychloroquine for Patients Diagnosed with Mild to Moderate COVID-19 Infections
title_full A Randomized, Double-Blind, Multicenter Clinical Study Comparing the Efficacy and Safety of a Drug Combination of Lopinavir/Ritonavir-Azithromycin, Lopinavir/Ritonavir-Doxycycline, and Azithromycin-Hydroxychloroquine for Patients Diagnosed with Mild to Moderate COVID-19 Infections
title_fullStr A Randomized, Double-Blind, Multicenter Clinical Study Comparing the Efficacy and Safety of a Drug Combination of Lopinavir/Ritonavir-Azithromycin, Lopinavir/Ritonavir-Doxycycline, and Azithromycin-Hydroxychloroquine for Patients Diagnosed with Mild to Moderate COVID-19 Infections
title_full_unstemmed A Randomized, Double-Blind, Multicenter Clinical Study Comparing the Efficacy and Safety of a Drug Combination of Lopinavir/Ritonavir-Azithromycin, Lopinavir/Ritonavir-Doxycycline, and Azithromycin-Hydroxychloroquine for Patients Diagnosed with Mild to Moderate COVID-19 Infections
title_sort randomized, double-blind, multicenter clinical study comparing the efficacy and safety of a drug combination of lopinavir/ritonavir-azithromycin, lopinavir/ritonavir-doxycycline, and azithromycin-hydroxychloroquine for patients diagnosed with mild to moderate covid-19 infections
publisher Hindawi
publishDate 2021
url https://repository.unair.ac.id/123735/2/C-21%20Artikel.pdf
https://repository.unair.ac.id/123735/1/C-21%20Kualitas%20Karil.pdf
https://repository.unair.ac.id/123735/3/C-21%20Similarity.pdf
https://repository.unair.ac.id/123735/
https://www.hindawi.com/journals/bri/2021/6685921/
https://doi.org/10.1155/2021/6685921
_version_ 1764209111963009024
spelling id-langga.1237352023-04-16T13:28:27Z https://repository.unair.ac.id/123735/ A Randomized, Double-Blind, Multicenter Clinical Study Comparing the Efficacy and Safety of a Drug Combination of Lopinavir/Ritonavir-Azithromycin, Lopinavir/Ritonavir-Doxycycline, and Azithromycin-Hydroxychloroquine for Patients Diagnosed with Mild to Moderate COVID-19 Infections Purwati, - Budiono, - Brian Eka Rachman, - Yulistiani, - Andang Miatmoko, - Nasronudin, - Soroy Lardo, - Yongki Iswandi Purnama, - Mafidhatul Laely, - Ike Rochmad, - Taufik Ismail, - Sri Wulandari, - Dwi Setyawan, - Alfian Nur Rosyid, - Herley Windo Setiawan, - Prastuti Asta Wulaningrum, - Tri Pudy Asmarawati, - Erika Marfiani, - Shinta Karina Yuniati, - Muhammad Rabiul Fuadi, - Pepy Dwi Endraswari, - Purwaningsih, - Eryk Hendrianto, - Deya Karsari, - Aristika Dinaryanti, - Nora Ertanti, - Igo Syaiful Ihsan, - Disca Sandyakala Purnama, - Yuni Indrayani, - R Medicine RS Pharmacy and materia medica RS1-441 Pharmacy and materia medica RS200-201 Pharmaceutical dosage forms Background. At the present time, COVID-19 vaccines are at the testing stage, and an effective treatment for COVID-19 incorporating appropriate safety measures remains the most significant obstacle to be overcome. A strategic countermeasure is, therefore, urgently required. Aim. This study aims to evaluate the efficacy and safety of a combination of lopinavir/ritonavir-azithromycin, lopinavir/ritonavir-doxycycline, and azithromycin-hydroxychloroquine used to treat patients with mild to moderate COVID-19 infections. Setting and Design. This study was conducted at four different clinical study sites in Indonesia. The subjects gave informed consent for their participation and were confirmed as being COVID-19-positive by means of an RT-PCR test. The present study constituted a randomized, double-blind, and multicenter clinical study of patients diagnosed with mild to moderate COVID-19 infection. Materials and Methods. Six treatment groups participated in this study: a Control group administered with a 500 mg dose of azithromycin; Group A which received a 200/50 mg dose of lopinavir/ritonavir and 500 mg of azithromycin; Group B treated with a 200/50 mg dose of lopinavir/ritonavir and 200 mg of doxycycline; Group C administered with 200 mg of hydroxychloroquine and 500 mg of azithromycin; Group D which received a 400/100 mg dose of lopinavir/ritonavir and 500 mg of azithromycin; and Group E treated with a 400/100 mg dose of lopinavir/ritonavir and 200 mg of doxycycline. Results. 754 subjects participated in this study: 694 patients (92.4%) who presented mild symptoms and 57 patients (7.6%) classified as suffering from a moderate case of COVID-19. On the third day after treatment, 91.7%–99.2% of the subjects in Groups A–E were confirmed negative by a PCR swab test compared to 26.9% in the Control group. Observation of all groups which experienced a significant decrease in virus load between day 1 and day 7 was undertaken. Other markers, such as CRP and IL-6, were significantly lower in all treatment groups ( and ) than in the Control group. Furthermore, IL-10 and TNF-α levels were significantly elevated in all treatment groups (). The administration of azithromycin to the Control group increased CRP and IL-6 levels, while reduced IL-10 and TNF-α on day 7 () compared with day 1. Decreases in ALT and AST levels were observed in all groups (). There was an increase in creatinine in the serum level of the Control, C, D, and E groups (), whereas the BUN level was elevated in all groups (). Conclusions. The study findings suggest that the administration of lopinavir/ritonavir-doxycycline, lopinavir/ritonavir-azithromycin, and azithromycin-hydroxychloroquine as a dual drug combination produced a significantly rapid PCR conversion rate to negative in three-day treatment of mild to moderate COVID-19 cases. Further studies should involve observation of older patients with severe clinical symptoms in order to collate significant amounts of demographic data. Hindawi 2021-02-09 Article PeerReviewed text en https://repository.unair.ac.id/123735/2/C-21%20Artikel.pdf text en https://repository.unair.ac.id/123735/1/C-21%20Kualitas%20Karil.pdf text en https://repository.unair.ac.id/123735/3/C-21%20Similarity.pdf Purwati, - and Budiono, - and Brian Eka Rachman, - and Yulistiani, - and Andang Miatmoko, - and Nasronudin, - and Soroy Lardo, - and Yongki Iswandi Purnama, - and Mafidhatul Laely, - and Ike Rochmad, - and Taufik Ismail, - and Sri Wulandari, - and Dwi Setyawan, - and Alfian Nur Rosyid, - and Herley Windo Setiawan, - and Prastuti Asta Wulaningrum, - and Tri Pudy Asmarawati, - and Erika Marfiani, - and Shinta Karina Yuniati, - and Muhammad Rabiul Fuadi, - and Pepy Dwi Endraswari, - and Purwaningsih, - and Eryk Hendrianto, - and Deya Karsari, - and Aristika Dinaryanti, - and Nora Ertanti, - and Igo Syaiful Ihsan, - and Disca Sandyakala Purnama, - and Yuni Indrayani, - (2021) A Randomized, Double-Blind, Multicenter Clinical Study Comparing the Efficacy and Safety of a Drug Combination of Lopinavir/Ritonavir-Azithromycin, Lopinavir/Ritonavir-Doxycycline, and Azithromycin-Hydroxychloroquine for Patients Diagnosed with Mild to Moderate COVID-19 Infections. Biochemistry Research International, 2021. pp. 1-12. ISSN 2090-2255 https://www.hindawi.com/journals/bri/2021/6685921/ https://doi.org/10.1155/2021/6685921