Umeå universitets logga

umu.sePublikationer
Ändra sökning
RefereraExporteraLänk till posten
Permanent länk

Direktlänk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
A Phase 2 Trial of the Effect of Antiandrogen Therapy on COVID-19 Outcome: No Evidence of Benefit, Supported by Epidemiology and In Vitro Data
Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Avdelningen för virologi. Umeå universitet, Medicinska fakulteten, Molekylär Infektionsmedicin, Sverige (MIMS).ORCID-id: 0000-0001-8512-0535
Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Avdelningen för virologi.ORCID-id: 0000-0001-5109-9408
Visa övriga samt affilieringar
2022 (Engelska)Ingår i: European Urology, ISSN 0302-2838, E-ISSN 1873-7560, Vol. 81, nr 3, s. 285-293Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: Men are more severely affected by COVID-19. Testosterone may influence SARS-CoV-2 infection and the immune response.

Objective: To clinically, epidemiologically, and experimentally evaluate the effect of antiandrogens on SARS-CoV-2 infection.

Designs, settings, and participants: A randomized phase 2 clinical trial (COVIDENZA) enrolled 42 hospitalized COVID-19 patients before safety evaluation. We also conducted a population-based retrospective study of 7894 SARS-CoV-2–positive prostate cancer patients and an experimental study using an air-liquid interface three-dimensional culture model of primary lung cells.

Intervention: In COVIDENZA, patients were randomized 2:1 to 5 d of enzalutamide or standard of care.

Outcome measurements: The primary outcomes in COVIDENZA were the time to mechanical ventilation or discharge from hospital. The population-based study investigated risk of hospitalization, intensive care, and death from COVID-19 after androgen inhibition.

Results and limitations: Enzalutamide-treated patients required longer hospitalization (hazard ratio [HR] for discharge from hospital 0.43, 95% confidence interval [CI] 0.20–0.93) and the trial was terminated early. In the epidemiological study, no preventive effects were observed. The frail population of patients treated with androgen deprivation therapy (ADT) in combination with abiraterone acetate or enzalutamide had a higher risk of dying from COVID-19 (HR 2.51, 95% CI 1.52–4.16). In vitro data showed no effect of enzalutamide on virus replication. The epidemiological study has limitations that include residual confounders.

Conclusions: The results do not support a therapeutic effect of enzalutamide or preventive effects of bicalutamide or ADT in COVID-19. Thus, these antiandrogens should not be used for hospitalized COVID-19 patients or as prevention for COVID-19. Further research on these therapeutics in this setting are not warranted.

Patient summary: We studied whether inhibition of testosterone could diminish COVID-19 symptoms. We found no evidence of an effect in a clinical study or in epidemiological or experimental investigations. We conclude that androgen inhibition should not be used for prevention or treatment of COVID-19.

Ort, förlag, år, upplaga, sidor
Elsevier, 2022. Vol. 81, nr 3, s. 285-293
Nyckelord [en]
COVID-19, SARS-CoV-2, Antiandrogen, Randomized trial, Enzalutamide, Bicalutamide, Androgen deprivation therapy
Nationell ämneskategori
Cancer och onkologi Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi Urologi och njurmedicin Infektionsmedicin
Identifikatorer
URN: urn:nbn:se:umu:diva-190911DOI: 10.1016/j.eururo.2021.12.013ISI: 000809752100020Scopus ID: 2-s2.0-85122412349OAI: oai:DiVA.org:umu-190911DiVA, id: diva2:1623939
Forskningsfinansiär
Knut och Alice Wallenbergs Stiftelse, 2020.0182ProstatacancerförbundetCancerfonden, 2017/478Cancerfonden, 20 1055 PjFHjärt-Lungfonden, 20200385Region Västerbotten, RV-836351Region Västerbotten, RV-939769Tillgänglig från: 2022-01-02 Skapad: 2022-01-02 Senast uppdaterad: 2023-04-25Bibliografiskt granskad

Open Access i DiVA

fulltext(2129 kB)146 nedladdningar
Filinformation
Filnamn FULLTEXT02.pdfFilstorlek 2129 kBChecksumma SHA-512
e7fc74835e8a1dc073ab915684901aff7d3f19629024fd43abbdb676668204194a99d77e5dd11060283f4954ed3d72f2ee0e22d62a488574bd04a9c99f673e61
Typ fulltextMimetyp application/pdf

Övriga länkar

Förlagets fulltextScopus

Person

Rosendal, EbbaLenman, AnnasaraFonseca Rodriguez, OsvaldoRepo, JohannaStyrke, JohanAngelin, MartinLindquist, ElisabethAllard, AnnikaBecker, MiriamRudolfsson, Stina H.Buckland, RobertAhlm, ClasFors Connolly, Anne-MarieÖverby, Anna K.Josefsson, Andreas

Sök vidare i DiVA

Av författaren/redaktören
Rosendal, EbbaLenman, AnnasaraFonseca Rodriguez, OsvaldoRepo, JohannaStyrke, JohanAngelin, MartinLindquist, ElisabethAllard, AnnikaBecker, MiriamRudolfsson, Stina H.Buckland, RobertAhlm, ClasFors Connolly, Anne-MarieÖverby, Anna K.Josefsson, Andreas
Av organisationen
Avdelningen för virologiMolekylär Infektionsmedicin, Sverige (MIMS)Institutionen för klinisk mikrobiologiUrologi och andrologiWallenberg centrum för molekylär medicin vid Umeå universitet (WCMM)
I samma tidskrift
European Urology
Cancer och onkologiFolkhälsovetenskap, global hälsa, socialmedicin och epidemiologiUrologi och njurmedicinInfektionsmedicin

Sök vidare utanför DiVA

GoogleGoogle Scholar
Totalt: 187 nedladdningar
Antalet nedladdningar är summan av nedladdningar för alla fulltexter. Det kan inkludera t.ex tidigare versioner som nu inte längre är tillgängliga.

doi
urn-nbn

Altmetricpoäng

doi
urn-nbn
Totalt: 399 träffar
RefereraExporteraLänk till posten
Permanent länk

Direktlänk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf