Nitazoxanide for COVID-19: real-time analysis of all 6 studies

Download Image


4/20	Early	Rossignol et al., medRxiv, doi:10.1101/2021.04.19.21255441 (Preprint)	death, ↑206.0%, p=0.49	Early treatment with nitazoxanide prevents worsening of mild and moderate COVID-19 and subsequent hospitalization
	Details RCT with 184 outpatients treated with an extended release formulation of nitazoxanide, and 195 controls, showing lower hospitalization and progression to severe disease with treatment. There was one COVID-19 related death in the treatment..
4/20	Details Source PDF Early treatment study Early treatment study
	Rossignol et al., medRxiv, doi:10.1101/2021.04.19.21255441 (Preprint)
	Early treatment with nitazoxanide prevents worsening of mild and moderate COVID-19 and subsequent hospitalization
	RCT with 184 outpatients treated with an extended release formulation of nitazoxanide, and 195 controls, showing lower hospitalization and progression to severe disease with treatment. There was one COVID-19 related death in the treatment arm. risk of death, 206.0% higher, RR 3.06, p = 0.49, treatment 1 of 184 (0.5%), control 0 of 195 (0.0%), continuity correction due to zero event. risk of hospitalization, 78.8% lower, RR 0.21, p = 0.22, treatment 1 of 184 (0.5%), control 5 of 195 (2.6%). risk of COVID-19 severe case, 84.9% lower, RR 0.15, p = 0.07, treatment 1 of 184 (0.5%), control 7 of 195 (3.6%). risk of COVID-19 severe case, 83.9% lower, RR 0.16, p = 0.07, treatment 1 of 112 (0.9%), control 7 of 126 (5.6%), high-risk subgroup. time to sustained response, 7.5% higher, relative time 1.08, treatment 184, control 195. Rossignol et al., 4/20/2021, Double Blind Randomized Controlled Trial, USA, North America, preprint, 8 authors.
	Share Tweet Submit Corrections or Comments
3/5	Early	Silva et al., medRxiv, doi:10.1101/2021.03.03.21252509 (Preprint)	viral+, ↓26.5%, p=0.36	Efficacy of Nitazoxanide in reducing the viral load in COVID-19 patients. Randomized, placebo-controlled, single-blinded, parallel group, pilot study
	Details Small RCT with 23 nitazoxanide and 13 control patients showing significantly more patients achieved over 35% reduction in viral load from baseline. NCT04463264.
3/5	Details Source PDF Early treatment study Early treatment study
	Silva et al., medRxiv, doi:10.1101/2021.03.03.21252509 (Preprint)
	Efficacy of Nitazoxanide in reducing the viral load in COVID-19 patients. Randomized, placebo-controlled, single-blinded, parallel group, pilot study
	Small RCT with 23 nitazoxanide and 13 control patients showing significantly more patients achieved over 35% reduction in viral load from baseline. NCT04463264. relative mean improvement in Ct, 26.5% lower, RR 0.74, p = 0.36, treatment 23, control 13. risk of viral load reduction < 35% at day 7, 38.3% lower, RR 0.62, p = 0.08, treatment 12 of 23 (52.2%), control 11 of 13 (84.6%). Silva et al., 3/5/2021, Single Blind Randomized Controlled Trial, Argentina, South America, preprint, 11 authors.
	Share Tweet Submit Corrections or Comments
2/16	Early	Elalfy et al., J. Med. Virol., doi:10.1002/jmv.26880 (Peer Reviewed)	viral+, ↓86.9%, p<0.0001	Effect of a combination of Nitazoxanide, Ribavirin and Ivermectin plus zinc supplement (MANS.NRIZ study) on the clearance of mild COVID-1
	Details Non-randomized controlled trial with 62 mild and early moderate patients with home treatment with ivermectin + nitazoxanide + ribavirin + zinc, showing significantly faster viral clearance.
2/16	Details Source PDF Early treatment study Early treatment study
	Elalfy et al., J. Med. Virol., doi:10.1002/jmv.26880 (Peer Reviewed)
	Effect of a combination of Nitazoxanide, Ribavirin and Ivermectin plus zinc supplement (MANS.NRIZ study) on the clearance of mild COVID-1
	Non-randomized controlled trial with 62 mild and early moderate patients with home treatment with ivermectin + nitazoxanide + ribavirin + zinc, showing significantly faster viral clearance. risk of no virological cure, 86.9% lower, RR 0.13, p < 0.001, treatment 7 of 62 (11.3%), control 44 of 51 (86.3%), day 15. risk of no virological cure, 58.1% lower, RR 0.42, p < 0.001, treatment 26 of 62 (41.9%), control 51 of 51 (100.0%), day 7. Elalfy et al., 2/16/2021, retrospective, Egypt, Middle East, peer-reviewed, 15 authors, this trial uses multiple treatments in the treatment arm (combined with ivermectin, ribavirin, and zinc) - results of individual treatments may vary.
	Share Tweet Submit Corrections or Comments
1/22	Late	Blum et al., EClinicalMedicine, doi:10.1016/j.eclinm.2021.100981 (preprint 1/22) (Peer Reviewed)	death, ↓66.7%, p=0.25	Nitazoxanide superiority to placebo to treat moderate COVID-19 – A Pilot prove of concept randomized double-blind clinical trial
	Details RCT with 25 nitazoxanide patients and 25 control patients, showing improved virological and clinical outcomes with treatment. Authors also perform an in vitro study in Vero E6 cells showing 90% inhibition with 0.5µM, with no cytotoxicity..
1/22	Details Source PDF Late treatment study Late treatment study
	Blum et al., EClinicalMedicine, doi:10.1016/j.eclinm.2021.100981 (preprint 1/22) (Peer Reviewed)
	Nitazoxanide superiority to placebo to treat moderate COVID-19 – A Pilot prove of concept randomized double-blind clinical trial
	RCT with 25 nitazoxanide patients and 25 control patients, showing improved virological and clinical outcomes with treatment. Authors also perform an in vitro study in Vero E6 cells showing 90% inhibition with 0.5µM, with no cytotoxicity. NCT04348409. risk of death, 66.7% lower, RR 0.33, p = 0.25, treatment 2 of 25 (8.0%), control 6 of 25 (24.0%). risk of mechanical ventilation, 62.5% lower, RR 0.38, p = 0.17, treatment 3 of 25 (12.0%), control 8 of 25 (32.0%). relative severity scores, 20.2% lower, RR 0.80, treatment 25, control 25. hospitalization time, 55.7% lower, relative time 0.44, p = 0.02, treatment 25, control 25. risk of no virological cure, 89.8% lower, RR 0.10, p = 0.03, treatment 0 of 23 (0.0%), control 4 of 19 (21.1%), continuity correction due to zero event, day 21. Blum et al., 1/22/2021, Double Blind Randomized Controlled Trial, Brazil, South America, peer-reviewed, 17 authors.
	Share Tweet Submit Corrections or Comments
11/4	Early	Cadegiani et al., New Microbes and New Infections, doi:10.1016/j.nmni.2021.100915 (preprint 11/4/2020) (Peer Reviewed)	death, ↓87.8%, p=0.08	Early COVID-19 Therapy with azithromycin plus nitazoxanide, ivermectin or hydroxychloroquine in Outpatient Settings Significantly Improved COVID-19 outcomes compared to Known outcomes in untreated patients
	Details Comparison of HCQ, nitazoxanide, and ivermectin showing similar effectiveness for overall clinical outcomes in COVID-19 when used before seven days of symptoms, and overwhelmingly superior compared to the untreated COVID-19 population, ev..
11/4	Details Source PDF Early treatment study Early treatment study
	Cadegiani et al., New Microbes and New Infections, doi:10.1016/j.nmni.2021.100915 (preprint 11/4/2020) (Peer Reviewed)
	Early COVID-19 Therapy with azithromycin plus nitazoxanide, ivermectin or hydroxychloroquine in Outpatient Settings Significantly Improved COVID-19 outcomes compared to Known outcomes in untreated patients
	Comparison of HCQ, nitazoxanide, and ivermectin showing similar effectiveness for overall clinical outcomes in COVID-19 when used before seven days of symptoms, and overwhelmingly superior compared to the untreated COVID-19 population, even for those outcomes not influenced by placebo effect, at least when combined with azithromycin, and vitamin C, D and zinc in the majority of the cases. 585 patients with mean treatment delay 2.9 days. There was no hospitalization, mechanical ventilation, or mortality with treatment. risk of death, 87.8% lower, RR 0.12, p = 0.08, treatment 0 of 357 (0.0%), control 2 of 137 (1.5%), continuity correction due to zero event, control group 1. risk of mechanical ventilation, 97.0% lower, RR 0.03, p < 0.001, treatment 0 of 357 (0.0%), control 9 of 137 (6.6%), continuity correction due to zero event, control group 1. risk of hospitalization, 99.0% lower, RR 0.01, p < 0.001, treatment 0 of 357 (0.0%), control 27 of 137 (19.7%), continuity correction due to zero event, control group 1. Cadegiani et al., 11/4/2020, prospective, Brazil, South America, peer-reviewed, 4 authors.
	Share Tweet Submit Corrections or Comments
10/23	Early	Rocco et al., European Respiratory Journal, doi:10.1183/13993003.03725-2020 (preprint 10/23/20) (Peer Reviewed)	ICU, ↑404.1%, p=0.24	Early use of nitazoxanide in mild Covid-19 disease: randomized, placebo-controlled trial (preprint 10/23)
	Details RCT 392 patients, median treatment delay 5 days, showing improved viral recovery at 5 days. Symptom recovery was no different at 5 days, and the treatment arm had two ICU admissions compared to zero for control. There were no serious adve..
10/23	Details Source PDF Early treatment study Early treatment study
	Rocco et al., European Respiratory Journal, doi:10.1183/13993003.03725-2020 (preprint 10/23/20) (Peer Reviewed)
	Early use of nitazoxanide in mild Covid-19 disease: randomized, placebo-controlled trial (preprint 10/23)
	RCT 392 patients, median treatment delay 5 days, showing improved viral recovery at 5 days. Symptom recovery was no different at 5 days, and the treatment arm had two ICU admissions compared to zero for control. There were no serious adverse events. risk of ICU admission, 404.1% higher, RR 5.04, p = 0.24, treatment 2 of 194 (1.0%), control 0 of 198 (0.0%), continuity correction due to zero event, table S3. risk of hospitalization, 2.1% higher, RR 1.02, p = 1.00, treatment 5 of 194 (2.6%), control 5 of 198 (2.5%), table S3. risk of no recovery, 15.8% higher, RR 1.16, p = 0.37, treatment 59 of 194 (30.4%), control 52 of 198 (26.3%), day 5. relative viral load, 12.1% lower, RR 0.88, p = 0.006, treatment 194, control 198, day 5. risk of no virological cure, 14.3% lower, RR 0.86, p = 0.009, treatment 136 of 194 (70.1%), control 162 of 198 (81.8%), day 5. Rocco et al., 10/23/2020, Randomized Controlled Trial, Brazil, South America, peer-reviewed, 29 authors.
	Share Tweet Submit Corrections or Comments

Please send us corrections, updates, or comments. Vaccines and treatments are both extremely valuable and complementary. All practical, effective, and safe means should be used. Elimination of COVID-19 is a race against viral evolution. No treatment, vaccine, or intervention is 100% available and effective for all current and future variants. Denying the efficacy of any method increases the risk of COVID-19 becoming endemic; and increases mortality, morbidity, and collateral damage. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. Treatment protocols for physicians are available from the FLCCC.

Thanks for your feedback! Please search before submitting papers and note that studies are listed under the date they were first available, which may be the date of an earlier preprint.

Submit