#Metformin RCT on 41% prevention of #LongCOVID with acute #COVID19 treatment is now published in @TheLancetInfDis at:
doi.org
N=1126 with long term follow up (~5% lost by 9mo)
10.4% vs. 6.3% LC incidence.
Double blind RCT using identical matched placebo.
Cost $1
doi.org
N=1126 with long term follow up (~5% lost by 9mo)
10.4% vs. 6.3% LC incidence.
Double blind RCT using identical matched placebo.
Cost $1
The distribution of symptoms reported over time was similar as others have found. The figure (a new additional from the original pre-print) displays the freq of symptoms reported over 9 months among those wih a long covid diagnosis vs. no diagnosis.
#LongCovid symptoms interfered with both the ability to work and affected leisure activities in about half of those with LC. This very, very slowly decreased over time.
As this was a 3x2 factorial randomized trial, we also looked at #ivermectin at median dose of 430 mcg/kg/d x3d and low-dose fluvoxamine.
Acute treatment of #COVID19 with either of these did not have any subsequent benefit for reducing #LongCovid
Acute treatment of #COVID19 with either of these did not have any subsequent benefit for reducing #LongCovid
For #ivermectin, there were not any particular subgroups who appeared to benefit for preventing #LongCovid. This is very null, no effect.
Similarly, we did not observe any benefit with low dose #fluvoxamine (50mg 2x/day) for preventing #LongCovid in the Covid-Out trial.
And with fluvoxamine, there was no particular subgroup who stood out as having any differential effect.
Subgroups are often way OVER interpreted. The purpose is to look for consistency of the direction of effect.
Subgroups are often way OVER interpreted. The purpose is to look for consistency of the direction of effect.
As has been shared before, #Metformin reduced 28-day hospitalization from 2.9% to 1.2% (P=0.034). That's a 58% reduction in the hazard of being hospitalized through 28-days.
These are the exact hosptialization numbers over time. As focused on by @NEJM and @NIHCOVIDTxGuide, there was no statistical reduction in hospitaliation by day 14. After Day 15, a statistical reduction in hospitalization occurred with #Metformin. ~50% were vaccinated
Subgroup analysis for metformin is generally consistent across apriori identified subgroups. Once again, I would not over-interpret any particular subgroup. How a particular subgroup is cut could determine the exact point estimate, and these subgroups are smaller than overall.
For instance, the overall vaccine group is less than the unvaccinated. Yet if you take people with a booster or recent primary vaccine <6mo, the Hazard Ratio is 0.66 (0.28 to 1.58) in the direction of benefit.
We could have divided up subgroups by astrologic signs to find β¬οΈorβ¬οΈ
We could have divided up subgroups by astrologic signs to find β¬οΈorβ¬οΈ
As an example, in a prior trial those who were a Libra or Gemini treated with aspirin did not statistically benefit from Aspirin after a heart attack. Is that plausable? No So I don't over-interpret subgroups.
ncbi.nlm.nih.gov
(Thank you James Watson, fo this example)
ncbi.nlm.nih.gov
(Thank you James Watson, fo this example)
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