Efficacy and safety of CVO PLUS CURATIF capsules, Malagasy improved traditional medication for treating COVID-19 a randomized, double-blind, placebo-controlled trial

R. Rakotosaona, S. A. Mioramalala, M. Rakotoarisoa, Antsa Rakotondrandriana, Emmanuel Randrianarivo, F. Rabetokotany, F. Rakoto, D. Razafimandimby, A. Ravélo, Fridolin Maminiaina, R. Rapelanoro, Z. Randriamanantany, R. Rakotoarivelo, O. R. Alson, A. Ratsimbasoa
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Abstract

Background There is currently no validated, effective, safe treatment for severe illness caused by SARS-CoV-2. CVO PLUS CURATIF (CVO+C) is a capsule formulation of two compounds of plant origin with anti-inflammatory and antiviral activities in vitro: artemisinin and 1,8-cineole. These compounds have been repurposed for possible use as an oral treatment against COVID-19. Methods We performed a phase 3 randomized clinical trials on patients over the age of 18 years with SARS-CoV-2 infection confirmed by RT-PCR and mild-to-moderate symptoms. Patients were randomly assigned to receive CVO+C (3 capsules per day) or placebo for 15 days. The primary outcome was the proportion of patients testing negative for SARS-CoV-2 by RT-PCR on day 28 and an absence of severe and serious adverse events. Recovery time, and biological parameters on days 7, 14, 21 and 28 of the trial were considered as secondary outcomes. The safety outcomes considered were adverse events on treatment. Results In total, 1,576 individuals underwent RT-PCR screening for SARS-CoV-2 infection during the study period. Positive test results were obtained for 591 subjects, 339 of whom met the inclusion criteria for this study. The final analysis included 339 subjects: 132 from the CVO+C arm and 144 from the placebo arm. Treatment efficacy differed significantly (p=0.011) between the CVO+C arm (87.1%, 95% CI: 81.3%-92.9%, with 70.45% of patients cured by day 14) and the placebo arm (75.0%, 95% CI: 67.8% - 82.1%), with an OR of 2.25. The median time to recovery was 14 days for the CVO+C group and 21 days for the placebo group. A total of 72 incidences of mild and moderate adverse events, 14 severe adverse events and no serious adverse events were observed in both groups. ConclusionCVO+C was effective for the treatment of mild-to-moderate COVID-19. None of the patients in the CVO+C arm displayed progression to the severe form of COVID-19. Liver kidney and metabolic functions were preserved in all patients.Trial registration: Registered at Pan African Clinical Trials Registry: (No. PACTR202103601407640, date of approval: 24/03/2021) and approved by the ethics committee of the Ministry of Public Health of Madagascar (approval No. 216 MINSANP/SG/AGMED/CERBM, 17/12/2020)
马达加斯加CVO PLUS CURATIF胶囊治疗新冠肺炎的疗效和安全性——一项随机、双盲、安慰剂对照试验
目前,对于SARS-CoV-2引起的严重疾病,还没有经过验证的、有效的、安全的治疗方法。CVO PLUS CURATIF (CVO+C)是一种胶囊制剂,含有两种植物源化合物,在体外具有抗炎和抗病毒活性:青蒿素和1,8-桉树脑。这些化合物已被重新利用,可能用于口服治疗COVID-19。方法对年龄在18岁以上、经RT-PCR确诊为SARS-CoV-2感染且症状轻至中度的患者进行了3期随机临床试验。患者被随机分配接受CVO+C(每天3粒)或安慰剂治疗15天。主要结局是第28天通过RT-PCR检测SARS-CoV-2阴性的患者比例,以及没有严重和严重不良事件。恢复时间和试验第7、14、21和28天的生物学参数被视为次要结局。考虑的安全性结果是治疗中的不良事件。结果在研究期间,共有1576人接受了SARS-CoV-2感染的RT-PCR筛查。591例受试者检测结果为阳性,其中339例符合本研究的纳入标准。最终分析包括339名受试者:132名来自CVO+C组,144名来自安慰剂组。CVO+C组(87.1%,95% CI: 81.3%-92.9%,其中70.45%的患者在第14天治愈)与安慰剂组(75.0%,95% CI: 67.8% - 82.1%)的治疗效果差异显著(p=0.011), OR为2.25。CVO+C组的中位恢复时间为14天,安慰剂组为21天。两组共发生轻中度不良事件72例,严重不良事件14例,无严重不良事件发生。结论cvo +C治疗轻中度COVID-19有效。CVO+C组中没有患者表现为COVID-19严重形式的进展。所有患者的肝肾及代谢功能均保持正常。试验注册:在泛非临床试验注册中心注册:PACTR202103601407640,批准日期:2021年3月24日),由马达加斯加公共卫生部伦理委员会批准(批准号:216 MINSANP/SG/AGMED/CERBM, 2020年12月17日)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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