Effect of Tenofovir Disoproxil Fumarate and Emtricitabine on nasopharyngeal SARS-CoV-2 viral load burden amongst outpatients with COVID-19: A pilot, randomized, open-label phase 2 trial.


Journal

EClinicalMedicine
ISSN: 2589-5370
Titre abrégé: EClinicalMedicine
Pays: England
ID NLM: 101733727

Informations de publication

Date de publication:
Aug 2021
Historique:
received: 18 05 2021
revised: 09 06 2021
accepted: 10 06 2021
pubmed: 6 7 2021
medline: 6 7 2021
entrez: 5 7 2021
Statut: ppublish

Résumé

Tenofovir and emtricitabine interfere with the SARS CoV-2 ribonucleic acid (RNA)-dependent RNA polymerase (RdRp). Several cohorts reported that people treated by tenofovir disoproxil fumarate and emtricitabine are less likely to develop SARS CoV-2 infection and related severe COVID-19. We conducted a pilot randomized, open-label, controlled, phase 2 trial at two hospitals in France. Eligible patients were consecutive outpatients (aged ≥18 years) with RT-PCR-confirmed SARS-CoV-2 infection and an interval from symptom onset to enrolment of 7 days or less. Patients were randomly assigned in a 1:1 ratio to receive oral tenofovir disoproxil fumarate and emtricitabine (2 pills on day 1 followed by 1 pill per day on days 2-7) or the standard of care. The primary and secondary endpoints were SARS-CoV-2 viral clearance from baseline assessed by cycle threshold (Ct) RT-PCR on nasopharyngeal swab collected at day 4 and day 7, respectively. A higher Ct corresponds to a lower SARS CoV-2 viral burden. Other endpoints were the time to recovery and the number of adverse events. This trial is registered with ClinicalTrials.gov, NCT04685512. From November, 20 In this pilot study of outpatients adult with recent non-severe COVID-19, tenofovir disoproxil fumarate plus emtricitabine appeared to accelerate the natural clearance of nasopharyngeal SARS-CoV-2 viral burden. These findings support the conduct of larger trials of tenofovir-based therapies for the prevention and early treatment of COVID-19. No external funding.

Sections du résumé

BACKGROUND BACKGROUND
Tenofovir and emtricitabine interfere with the SARS CoV-2 ribonucleic acid (RNA)-dependent RNA polymerase (RdRp). Several cohorts reported that people treated by tenofovir disoproxil fumarate and emtricitabine are less likely to develop SARS CoV-2 infection and related severe COVID-19.
METHODS METHODS
We conducted a pilot randomized, open-label, controlled, phase 2 trial at two hospitals in France. Eligible patients were consecutive outpatients (aged ≥18 years) with RT-PCR-confirmed SARS-CoV-2 infection and an interval from symptom onset to enrolment of 7 days or less. Patients were randomly assigned in a 1:1 ratio to receive oral tenofovir disoproxil fumarate and emtricitabine (2 pills on day 1 followed by 1 pill per day on days 2-7) or the standard of care. The primary and secondary endpoints were SARS-CoV-2 viral clearance from baseline assessed by cycle threshold (Ct) RT-PCR on nasopharyngeal swab collected at day 4 and day 7, respectively. A higher Ct corresponds to a lower SARS CoV-2 viral burden. Other endpoints were the time to recovery and the number of adverse events. This trial is registered with ClinicalTrials.gov, NCT04685512.
FINDINGS RESULTS
From November, 20
INTERPRETATION CONCLUSIONS
In this pilot study of outpatients adult with recent non-severe COVID-19, tenofovir disoproxil fumarate plus emtricitabine appeared to accelerate the natural clearance of nasopharyngeal SARS-CoV-2 viral burden. These findings support the conduct of larger trials of tenofovir-based therapies for the prevention and early treatment of COVID-19.
FUNDING BACKGROUND
No external funding.

Identifiants

pubmed: 34222849
doi: 10.1016/j.eclinm.2021.100993
pii: S2589-5370(21)00273-X
pmc: PMC8235994
doi:

Banques de données

ClinicalTrials.gov
['NCT04685512']

Types de publication

Journal Article

Langues

eng

Pagination

100993

Informations de copyright

© 2021 The Author(s).

Déclaration de conflit d'intérêts

J.-JP reports personal fees and grant support from Gilead Sciences, Merck Sharp & Dohme and ViiV Healthcare outside the submitted work. L.H. reports personal fees and non-financial support from Gilead Sciences, Janssen-Cilag, Merck Sharp & Dohme and ViiV Healthcare outside the submitted work. Other authors declare no competing interests.

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Auteurs

Jean-Jacques Parienti (JJ)

Department of Clinical Research and Innovation, Caen University Hospital, Caen, France.
Department of Infectious Diseases, Caen University Hospital, Caen, France.
EA 2656 - Groupe de recherche sur l'adaptation microbienne 2.0, UNICAEN-Université de Caen Normandie, Caen, France.

Thierry Prazuck (T)

Department of Infectious Diseases, Orléans Regional Hospital, Orléans, France.

Laure Peyro-Saint-Paul (L)

Department of Clinical Research and Innovation, Caen University Hospital, Caen, France.

Anna Fournier (A)

Department of Infectious Diseases, Caen University Hospital, Caen, France.
EA 2656 - Groupe de recherche sur l'adaptation microbienne 2.0, UNICAEN-Université de Caen Normandie, Caen, France.

Cécile Valentin (C)

Department of Clinical Research and Innovation, Caen University Hospital, Caen, France.

Sylvie Brucato (S)

Department of Clinical Research and Innovation, Caen University Hospital, Caen, France.

Renaud Verdon (R)

Department of Infectious Diseases, Caen University Hospital, Caen, France.
EA 2656 - Groupe de recherche sur l'adaptation microbienne 2.0, UNICAEN-Université de Caen Normandie, Caen, France.

Aymeric Sève (A)

Department of Infectious Diseases, Orléans Regional Hospital, Orléans, France.

Mathilda Colin (M)

Department of Infectious Diseases, Orléans Regional Hospital, Orléans, France.

Fabien Lesne (F)

Department of Virology, Orléans Regional Hospital, Orléans, France.

Jérome Guinard (J)

Department of Virology, Orléans Regional Hospital, Orléans, France.

Meriadeg Ar Gouilh (M)

EA 2656 - Groupe de recherche sur l'adaptation microbienne 2.0, UNICAEN-Université de Caen Normandie, Caen, France.
Department of Virology, Caen University Hospital, Caen, France.

Julia Dina (J)

EA 2656 - Groupe de recherche sur l'adaptation microbienne 2.0, UNICAEN-Université de Caen Normandie, Caen, France.
Department of Virology, Caen University Hospital, Caen, France.

Astrid Vabret (A)

EA 2656 - Groupe de recherche sur l'adaptation microbienne 2.0, UNICAEN-Université de Caen Normandie, Caen, France.
Department of Virology, Caen University Hospital, Caen, France.

Laurent Hocqueloux (L)

Department of Infectious Diseases, Orléans Regional Hospital, Orléans, France.

Classifications MeSH