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在疑似 COVID-19 的门诊患者中使用非布司他治疗:一项临床试验。

Febuxostat therapy in outpatients with suspected COVID-19: A clinical trial.

机构信息

Department of Infection Diseases, Antimicrobial Resistance Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.

Department of Radiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.

出版信息

Int J Clin Pract. 2020 Nov;74(11):e13600. doi: 10.1111/ijcp.13600. Epub 2020 Jul 17.

Abstract

BACKGROUND

The aim of this clinical trial was to evaluate the effects of febuxostat (FBX) in comparison with hydroxychloroquine (HCQ) on clinical symptoms, laboratory tests and chest CT findings in outpatients with moderate symptoms of COVID-19 infection.

METHODS

We conducted a clinical trial involving adult outpatients with the moderate respiratory illness following COVID-19 infection. Patients were randomly assigned to receive either FBX or HCQ for 5 days. The measured variables were needs to hospitalisation, clinical and laboratory data including fever, cough, breathing rate, C-Reactive Protein level, lymphocytes count at onset of admission and was well as at 5 days of treatments. In addition, CT findings were evaluated on admission and 14 days after initiation of treatment.

RESULTS

Sixty subjects were enrolled in the study with a 1 to 1 ratio in FBX and HCQ groups. On admission, fever (66.7%), cough (87%), tachypnoea (44.4%), dyspnoea (35%), elevated CRP value (94.4%) and lung involvement according to chest CT (100%) were documented in enrolled patients with insignificant difference between FBX and HCQ groups. Fever, cough and tachypnoea were significantly mitigated in both groups after five days of treatments without any significant differences between groups. The mean percentages of lung involvement were significantly reduced to 7.3% and 8% after 14 days of treatment with FBX and HCQ, respectively. In adult outpatients with moderate COVID-19 infection, the effectiveness of FBX and HCQ was not different in terms of resolution of clinical manifestations, laboratory tests and lung CT findings.

CONCLUSION

This trial suggests that FBX is as an alternative treatment to HCQ for COVID-19 infection and may be considered in patients with a contraindication or precaution to HCQ.

摘要

背景

本临床试验旨在评估非布司他(FBX)与羟氯喹(HCQ)相比在治疗 COVID-19 中度症状感染门诊患者的临床症状、实验室检查和胸部 CT 结果方面的效果。

方法

我们进行了一项涉及 COVID-19 感染后中度呼吸系统疾病的成年门诊患者的临床试验。患者被随机分配接受 FBX 或 HCQ 治疗 5 天。测量的变量包括住院需求、临床和实验室数据,包括发热、咳嗽、呼吸频率、C 反应蛋白水平、入院时和治疗 5 天时的淋巴细胞计数,以及 CT 检查结果。

结果

60 名患者入组研究,FBX 和 HCQ 组的比例为 1:1。入院时,所有患者均有发热(66.7%)、咳嗽(87%)、呼吸急促(44.4%)、呼吸困难(35%)、CRP 值升高(94.4%)和肺部 CT 显示肺受累(100%),FBX 和 HCQ 组之间无显著差异。两组患者在治疗 5 天后,发热、咳嗽和呼吸急促均明显缓解,两组间无显著差异。FBX 和 HCQ 治疗 14 天后,肺受累的平均百分比分别显著降低至 7.3%和 8%。在 COVID-19 中度感染的成年门诊患者中,FBX 和 HCQ 在缓解临床症状、实验室检查和肺部 CT 结果方面的疗效无差异。

结论

本试验表明,FBX 是治疗 COVID-19 感染的另一种选择,对于 HCQ 有禁忌证或慎用的患者可考虑使用。

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