Lowe: Favipiravir, lopinavir-ritonavir or combination therapy (FLARE): a randomised, double blind, 2x2 factorial placebo-controlled trial of early antiviral therapy in COVID-19

Lowe, 106 patient favipiravir early treatment RCT: 28% improved viral clearance [p=0.03] https://c19p.org/lowe

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Favipiravir, lopinavir-ritonavir or combination therapy (FLARE): a randomised, double blind, 2x2 factorial placebo-controlled trial of early antiviral therapy in COVID-19

Lowe et al., medRxiv, doi:10.1101/2022.02.11.22270775 (Preprint), FLARE, NCT04499677 (history)

15 Feb 2022 Source PDF Share Tweet

240 patient RCT comparing favipiravir, favipiravir + LPV/r, LPV/r, and placebo, showing improved viral clearance with favipiravir. Efficacy was lower in the combined favipiravir + LPV/r arm, where plasma levels of favipiravir were lower.

Favipiravir 1800mg twice daily on day 1 followed by 400mg four times daily on days 2-7.

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risk of ICU admission, 196.3% higher, RR 2.96, p = 1.00, treatment 1 of 54 (1.9%), control 0 of 52 (0.0%), continuity correction due to zero event (with reciprocal of the contrasting arm).

risk of hospitalization, 196.3% higher, RR 2.96, p = 1.00, treatment 1 of 54 (1.9%), control 0 of 52 (0.0%), continuity correction due to zero event (with reciprocal of the contrasting arm).

risk of no viral clearance, 28.4% lower, RR 0.72, p = 0.03, treatment 29 of 54 (53.7%), control 38 of 52 (73.1%), NNT 5.2, inverted to make RR<1 favor treatment, odds ratio converted to relative risk, day 5, primary outcome.

Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates

Lowe et al., 15 Feb 2022, Double Blind Randomized Controlled Trial, placebo-controlled, United Kingdom, preprint, 18 authors, study period 6 October, 2020 - 4 November, 2021, trial NCT04499677 (history) (FLARE).

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