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Antiandrogen COVID-19 studies. This analysis combines the results of several different antiandrogens. Results for individual treatments may vary. Proxalutamide is analyzed separately. Recent:
Ghandehari
Kotani
Barnette
Wadhwa
Hunt
Shah
Shaw.
Submit updates/corrections.
Aug 12
Early, Late, PrEP, PEP Covid Analysis (Preprint) (meta analysis)
meta-analysis
Antiandrogens for COVID-19: real-time meta analysis of 39 studies
Details   • Statistically significant improvements are seen for mortality, ventilation, recovery, cases, and viral clearance. 22 studies from 20 independent teams in 12 different countries show statistically significant improvements in isolation (1..
Aug 4
Meta Kotani et al., SSRN Electronic Journal, doi:10.2139/ssrn.4181700 (Preprint)
death, ↓60.0%, p=0.0004
Antiandrogen Agents in COVID-19: A Meta-Analysis of Randomized Trials
Details   Meta analysis of 12 studies, showing significantly lower mortality with antiandrogen treatment.
Jul 6
Late Barnette et al., NEJM Evidence, doi:10.1056/EVIDoa2200145
death, ↓55.2%, p=0.002
Oral Sabizabulin for High-Risk, Hospitalized Adults with Covid-19: Interim Analysis
Details   RCT with 98 hospitalized moderate/severe patients treated with sabizabulin and 52 control patients, showing lower mortality with treatment. Sabizabulin 9mg for up to 21 days. For more discussion see .
Jul 2
Late Wadhwa et al., medRxiv, doi:10.1101/2022.07.01.22277163 (Preprint)
progression, ↓72.4%, p=0.03
Phase 2 randomised placebo-controlled trial of spironolactone and dexamethasone versus dexamethasone in COVID-19 hospitalised patients in Delhi
Details   RCT 120 hospitalized patients in India, 74 treated with spironolactone and dexamethasone, and 46 with dexamethasone, showing lower progression with treatment. Spironolactone 50mg once daily day 1, 25mg once daily until day 21.
Jun 29
Early Hunt et al., Journal of General Internal Medicine, doi:10.1007/s11606-022-07701-3
death, ↓39.0%, p<0.0001
Medications Associated with Lower Mortality in a SARS-CoV-2 Positive Cohort of 26,508 Veterans
Details   Retrospective 26,508 consecutive COVID+ veterans in the USA, showing lower mortality with multiple treatments including anti-androgens. Treatment was defined as drugs administered ≥50% of the time within 2 weeks post-COVID+, and may be a ..
May 12
PrEPPEP Shah et al., JNCI Cancer Spectrum, doi:10.1093/jncics/pkac035
death, ↑16.0%, p=0.59
The Impact of Androgen Deprivation Therapy on COVID-19 Illness in Men With Prostate Cancer
Details   Retrospective 465 prostate cancer patients, showing no significant difference in COVID-19 outcomes with ADT.
May 10
Levels Yeap et al., European Journal of Endocrinology, doi:10.1530/EJE-22-0104 Higher premorbid serum testosterone predicts COVID-19-related mortality risk in men.
Details   Prospective UK Biobank study showing higher premorbid testosterone levels associated with higher COVID-19 mortality.
May 5
In Silico Saih et al., Physical Chemistry Research, doi:10.22036/pcr.2022.324549.2016
In Silico
In-Silico Molecular Docking, Validation, Drug-Likeness, and ADMET Studies of Antiandrogens to Use in the Fight against SARS-CoV-2
Details   In Silico study of several antiandrogens identifying strong candidates for inhibition of SARS-CoV-2. Apalutamide and bicalutamide showed the best binding affinity against TMPRSS2.
Apr 25
Late Gordon, M., 32nd European Congress of Clinical Microbiology & Infectious Diseases
death, ↓82.0%, p=0.04
Phase 2 study of oral sabizabulin for the treatment of SARS-CoV-2 in hospitalized patients at high risk for ARDS
Details   Phase 2 RCT of sabizabulin showing lower mortality with treatment. For more discussion see .
Apr 19
Late Nickols et al., JAMA Network Open, doi:10.1001/jamanetworkopen.2022.7852
death, ↓18.3%, p=0.66
Effect of Androgen Suppression on Clinical Outcomes in Hospitalized Men With COVID-19
Details   Early terminated RCT with 62 very late stage (79% on oxygen) degarelix patients and 34 placebo patients, showing no significant differences with treatment. For discussion of many issues with this study see .
Mar 31
Meta Meng et al., Journal of Infection, doi:10.1016/j.jinf.2022.03.020
meta-analysis
Protective trend of anti-androgen therapy during the COVID-19 pandemic: A meta-analysis
Details   Meta analysis of 15 antiandrogen studies showing a protective trend although there has been conflicting results to date.
Mar 29
PrEPPEP MacFadden et al., Open Forum Infectious Diseases, doi:10.1093/ofid/ofac156
cases, ↓7.0%, p=0.008
Screening Large Population Health Databases for Potential COVID-19 Therapeutics: A Pharmacopeia-Wide Association Study (PWAS) of Commonly Prescribed Medications
Details   Retrospective 26,121 cases and 2,369,020 controls ≥65yo in Canada, showing lower cases with chronic use of spironolactone.
Mar 14
Late Hsieh et al., Frontiers in Nutrition, doi:10.3389/fnut.2022.832321
death, ↓87.9%, p=0.13
Efficacy and Safety of Complementary Therapy With Jing Si Herbal Tea in Patients With Mild-To-Moderate COVID-19: A Prospective Cohort Study
Details   Prospective study of 260 hospitalized patients in Taiwan, 117 treated with herbal formula Jing Si Herbal Tea which includes antiandrogen glycyrrhiza glabra, showing improved recovery with treatment, with statistical significance for SpO2,..
Mar 7
PrEPPEP Lee et al., Frontiers in Medicine, doi:10.3389/fmed.2022.774773
severe case, ↓21.4%, p=0.03
A population-level analysis of the protective effects of androgen deprivation therapy against COVID-19 disease incidence and severity
Details   Retrospective 3,057 androgen deprivation therapy patients in the USA, and 36,096 control patients with cancer, showing lower risk of cases and severity with ADT.
Mar 1
Late Gomaa et al., Inflammopharmacology, doi:10.1007/s10787-022-00939-7
death, ↓90.9%, p=0.05
Advancing combination treatment with glycyrrhizin and boswellic acids for hospitalized patients with moderate COVID-19 infection: a randomized clinical trial
Details   RCT with 50 hospitalized COVID+ patients in Egypt, 25 treated with glycyrrhizin and boswellic acid, showing improved recovery with treatment. Glycyrrhizin 60mg and boswellic acid 200mg bid for 2 weeks. NCT04487964.
Feb 24
Review Kory et al., Journal of Clinical Medicine Research, doi:10.14740/jocmr4658 (Review)
review
“MATH+” Multi-Modal Hospital Treatment Protocol for COVID-19 Infection: Clinical and Scientific Rationale
Details   Review of the data supporting the MATH+ hospital treatment protocol for COVID-19.
Feb 7
Late Abbasi et al., Journal of the Endocrine Society, doi:10.1210/jendso/bvac017
death, ↓55.1%, p=0.10
A Randomized Trial of Sitagliptin and Spironolactone With Combination Therapy in Hospitalized Adults With COVID-19
Details   RCT including 51 spironolactone patients and 87 control patients in Iran, showing improved recovery with spironolactone, sitagliptin, and the combination of both.
Feb 5
Late Kotfis et al., Pharmaceuticals, doi:10.3390/ph15020200
death, ↓16.7%, p=1.00
Mineralocorticoid Receptor Antagonist (Potassium Canrenoate) Does Not Influence Outcome in the Treatment of COVID-19-Associated Pneumonia and Fibrosis—A Randomized Placebo Controlled Clinical Trial
Details   RCT with 24 patients treated with potassium canrenoate and 25 placebo patients in Poland, showing no significant differences.
Jan 21
Late Davarpanah et al., medRxiv, doi:10.1101/2022.01.21.22269322 (Preprint)
hosp., ↓78.3%, p=0.0008
Combination of Spironolactone and Sitagliptin Improves Clinical Outcomes of Outpatients with COVID-19: An Observational Study
Details   Prospective study of 206 outpatients in Iran, 103 treated with spironolactone and sitagliptin, showing lower hospitalization and faster recovery with treatment. spironolactone 100mg and sitagliptin 100mg daily.
Jan 31
PrEPPEP Lyon et al., Journal of Urology, doi:10.1097/JU.0000000000002180
death, ↓16.9%, p=0.61
5α-Reductase Inhibitors Are Associated with Reduced Risk of SARS-CoV-2 Infection: A Matched-Pair, Registry-Based Analysis
Details   Retrospective 944 5ARI users in the USA and 944 matched controls, showing lower risk of COVID-19 cases with treatment.
Dec 27
2021
Early Bhardwaja et al., Research Square, doi:10.21203/rs.3.rs-1165680/v1 (Preprint)
no disch., ↓36.8%, p=0.67
An integrative approach to clinical recovery for COVID-19 patients using an Ayurvedic formulation: A multicentric double-blind randomized control trial.
Details   Small RCT with 39 patients treated with NOQ19 and 37 placebo patients, showing improved recovery, without statistical significance. NOQ19 has multiple ingredients including curcumin and antiandrogen glycyrrhiza glabra. CTRI/2021/05/033790.
Dec 23
2021
PrEPPEP Gedeborg et al., Scandinavian Journal of Urology, doi:10.1080/21681805.2021.2019304
death, ↑25.0%, p=0.11
Androgen deprivation therapy, comorbidity, cancer stage and mortality from COVID-19 in men with prostate cancer
Details   Case control study with 474 patients that died of COVID-19 in Sweden, showing higher risk with ADT, without statistical significance.
Dec 14
2021
Late Welén et al., European Urology, doi:10.1016/j.eururo.2021.12.013
death, ↓79.6%, p=0.26
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
Details   Very small late stage RCT with 10 control patients and 29 enzalutamide patients, showing mixed results. Discharge and hospitalization time favored the control group, while viral load reduction was better with treatment on days 4&6 (day 4 ..
Dec 14
2021
PrEPPEP Welén et al., European Urology, doi:10.1016/j.eururo.2021.12.013
death, ↓2.0%, p=0.94
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
Details   Retrospective 7,894 COVID+ prostate cancer patients, analyzing patients on antiandrogen treatment, ADT, and ADT + abiraterone acetate or enzalutamide, showing mixed results and higher mortality for ADT + abiraterone acetate or enzalutamid..
Nov 25
2021
PrEPPEP Duarte et al., Infectious Agents and Cancer, doi:10.1186/s13027-021-00406-y
death, ↓11.2%, p=0.37
Impact of androgen deprivation therapy on mortality of prostate cancer patients with COVID-19: a propensity score-based analysis
Details   Retrospective 199 prostate cancer patients hospitalized with COVID-19 in Brazil, showing no significant difference in mortality with active ADT.
Nov 12
2021
PrEPPEP Schmidt et al., JAMA Network Open, doi:10.1001/jamanetworkopen.2021.34330
death, ↓20.4%, p=0.41
Association Between Androgen Deprivation Therapy and Mortality Among Patients With Prostate Cancer and COVID-19
Details   Retrospective 1,106 prostate cancer patients, showing no significant differences in COVID-19 outcomes with ADT.
Nov 1
2021
PrEPPEP Kazan et al., Türk Üroloji Dergisi/Turkish Journal of Urology, doi:10.5152/tud.2021.21278
hosp., ↑229.0%, p=0.20
The clinical impact of androgen deprivation therapy on SARS-CoV-2 infection rates and disease severity
Details   Retrospective 365 prostate cancer patients in Turkey, 138 treated with ADT, showing no significant differences with treatment.
Oct 13
2021
Late Ersoy et al., Aydin Sağlik Dergi̇si̇, doi:10.17932/IAU.ASD.2015.007/asd_v07i3002
death, ↓46.2%, p=0.002
Assessment Of The Efficacy Of Spironolactone For COVID-19 ARDS Patients
Details   Retrospective 30 COVID-19 ARDS ICU patients and 30 control patients, showing lower mortality with treatment.
Sep 13
2021
PrEPPEP Jiménez-Alcaide et al., The Prostate, doi:10.1002/pros.24232
death, ↓33.0%, p=0.41
Influence of androgen deprivation therapy on the severity of COVID‐19 in prostate cancer patients
Details   Retrospective 1,349 prostate cancer patients in Spain, 156 on ADT, showing no significant differences in COVID-19 outcomes with treatment.
Jul 31
2021
Late Ghandehari et al., Chest, doi:10.1016/j.chest.2021.02.024
death, ↑22.2%, p=1.00
Progesterone in Addition to Standard of Care vs Standard of Care Alone in the Treatment of Men Hospitalized With Moderate to Severe COVID-19
Details   RCT 42 hospitalized patients in the USA, showing improved recovery and lower progression with progesterone treatment.
Jul 27
2021
PrEPPEP Israel et al., Epidemiology and Global Health Microbiology and Infectious Disease, doi:10.7554/eLife.68165
hosp., ↓37.7%, p=0.01
Identification of drugs associated with reduced severity of COVID-19: A case-control study in a large population
Details   Case control study examining medication usage with a healthcare database in Israel, showing lower risk of hospitalization with dutasteride.
Jul 1
2021
PrEPPEP Shaw et al., Journal of Drugs in Dermatology, doi:10.36849/JDD.5843
cases, ↓6.0%, p=0.006
COVID-19 in Individuals Treated With Long-Term Hydroxychloroquine: A Propensity Score-Matched Analysis of Cicatricial Alopecia Patients
Details   PSM retrospective 144 alopecia patients in the USA, showing no significant difference in COVID-19 cases with anti-androgen use. The supplemental appendix is not available.
Jul 1
2021
Animal Leach et al., Nature Communications, doi:10.1038/s41467-021-24342-y
animal study
The antiandrogen enzalutamide downregulates TMPRSS2 and reduces cellular entry of SARS-CoV-2 in human lung cells
Details   In Vitro and animal study showing that the antiandrogen enzalutamide reduces TMPRSS2 levels in human lung cells and in mouse lungs.
Jun 5
2021
Review Mauvais-Jarvis et al., Endocrinology, doi:10.1210/endocr/bqab114 (Review)
review
Do Anti-androgens Have Potential as Therapeutics for COVID-19?
Details   Review of research related to the potential benefits of anti-androgrens for COVID-19.
Apr 30
2021
Late Zarehoseinzade et al., Medical Journal of The Islamic Republic of Iran, doi:10.47176/mjiri.35.30
death, ↓75.0%, p=0.36
Finasteride in hospitalized adult males with COVID-19: A risk factor for severity of the disease or an adjunct treatment: A randomized controlled clinical trial
Details   RCT 80 hospitalized COVID-19 patients in Iran, 40 treated with finasteride, showing no significant differences other than improved oxygen saturation on the 5th day with treatment. There was significantly more patients with diabetes in the..
Feb 23
2021
PrEPPEP Jeon et al., Frontiers in Medicine, doi:10.3389/fmed.2021.629176
cases, ↓77.0%, p=0.005
Effect of Spironolactone on COVID-19 in Patients With Underlying Liver Cirrhosis: A Nationwide Case-Control Study in South Korea
Details   Retrospective 6,462 liver cirrhosis patients in South Korea, with 67 COVID+ cases, showing significantly lower COVID-19 cases with spironolactone treatment. Death and ICU results per group are not provided. Complications in this study inc..
Feb 1
2021
PrEPPEP Klein et al., Journal of Urology, doi:10.1097/JU.0000000000001338
death, ↑123.9%, p=0.12
Androgen Deprivation Therapy in Men with Prostate Cancer Does Not Affect Risk of Infection with SARS-CoV-2
Details   Retrospective 1,779 prostate cancer patients, showing no significant differences in COVID-19 outcomes with ADT.
Feb 1
2021
Early Cadegiani et al., Cureus, doi:10.7759/cureus.13047
no recov., ↓62.0%, p=0.009
Early Antiandrogen Therapy With Dutasteride Reduces Viral Shedding, Inflammatory Responses, and Time-to-Remission in Males With COVID-19: A Randomized, Double-Blind, Placebo-Controlled Interventional Trial (EAT-DUTA AndroCoV Trial – Biochemical)
Details   RCT 130 outpatients in Brazil, 54 treated with dutasteride, showing faster recovery with treatment. All patients received nitazoxanide. There were no hospitalizations, mechanical ventilation, or deaths. Some percentages for viral clearanc..
Jan 29
2021
PrEPPEP Kwon et al., Annals of Oncology, doi:10.1016/j.annonc.2021.01.067
death, ↓21.1%, p=1.00
Androgen-deprivation therapy and SARS-CoV-2 in men with prostate cancer: findings from the University of California Health System registry
Details   Retrospective 5,211 prostate cancer patients, 799 on ADT, showing no significant differences in COVID-19 outcomes with treatment.
Dec 3
2020
Late Mareev et al., Кардиология, doi:10.18087/cardio.2020.11.n1440
no recov., ↓11.3%, p=0.47
Results of Open-Label non-Randomized Comparative Clinical Trial: “BromhexIne and Spironolactone for CoronаvirUs Infection requiring hospiTalization (BISCUIT)
Details   Prospective 103 PCR+ patients in Russia, 33 treated with bromexhine+spironolactone, showing lower PCR+ at day 10 or hospitalization >10 days with treatment. Bromhexine 8mg 4 times daily, spironolactone 25-50 mg/day for 10 days.
Nov 2
2020
PrEPPEP McCoy et al., Journal of the European Academy of Dermatology and Venereology, doi:10.1111/jdv.17021 5-alpha-reductase inhibitors are associated with reduced frequency of COVID-19 symptoms in males with androgenetic alopecia
Details   Retrospective 48 androgenetic alopecia patients in Brazil treated with dutasteride, compared with 48 propensity score matched androgenetic alopecia patients not taking any 5ARis, showing a statistically significant reduction in the freque..
Oct 6
2020
Early Cadegiani et al., medRxiv, doi:10.1101/2020.10.05.20206870 (Preprint)
recov. time, ↓76.7%, p=0.006
An open-label prospective observational study of antiandrogen and non-antiandrogen early pharmacological approaches in females with mild-to-moderate COVID-19. The Pre-AndroCoV Female Trial
Details   Prospective study of 270 female COVID-19 patients in Brazil, 75 with hyperandrogenism, of which 8 were on spironolactone. Results suggest that HA patients may be at increased risk, and that spironolactone use may reduce the risk compared ..
Sep 25
2020
Late Goren et al., Journal of the European Academy of Dermatology and Venereology, doi:10.1111/jdv.16953
ICU, ↓81.0%, p=0.08
Anti-androgens may protect against severe COVID-19 outcomes: results from a prospective cohort study of 77 hospitalized men
Details   Prospective study of 77 men hospitalized with COVID-19, 12 taking antiandrogens (9 dutasteride, 2 finasteride, 1 spironolactone), showing lower ICU admission with treatment (statistically significant with age-matched controls only when exc..
Sep 21
2020
PrEPPEP Lazzeri et al., medRxiv, doi:10.1101/2020.04.20.20068056 (Preprint)
death/ICU, ↑23.0%, p=0.33
Impact of anti-androgen therapies on COVID-19 susceptibility: a case-control study in male population from two COVID-19 regional centers of Lombardy (Italy)
Details   Retrospective case-control study in Italy with 943 male COVID-19 patients, 45 on chronic 5ARI treatment (finasteride/dutasteride). There was significantly fewer COVID-19 patients >55 on 5ARI treatment compared to age-matched controls (5.5..
Sep 11
2020
Late Vicenzi et al., Journal of Clinical Medicine, doi:10.3390/jcm9092943
death, ↓93.0%, p<0.0001
The Efficacy of the Mineralcorticoid Receptor Antagonist Canrenone in COVID-19 Patients
Details   Retrospective 69 consecutive hospitalized COVID-19 patients in Italy, 30 patients receiving canrenone, and 39 treated with vasodilator agents or renin–angiotensin–aldosterone system (RAAS) inhibitors, showing lower mortality with canrenone.
Aug 17
2020
PrEPPEP Bennani et al., Annals of Oncology, doi:10.1016/j.annonc.2020.08.2095
death, ↓94.9%, p=1.00
Androgen deprivation therapy may constitute a more effective COVID-19 prophylactic than therapeutic strategy
Details   Retrospective 118 prostate cancer patients, 4 on androgren deprivation therapy, not showing significant differences (as expected with only 4 patients in the treatment group).
Jul 9
2020
PrEPPEP Patel et al., Annals of Oncology, doi:10.1016/j.annonc.2020.06.023
death, ↓55.2%, p=0.22
Does androgen deprivation therapy protect against severe complications from COVID-19?
Details   Retrospective 58 prostate cancer patients in the USA, showing lower risk of hospitalization with ADT.
Jun 29
2020
PrEPPEP Koskinen et al., Annals of Oncology, doi:10.1016/j.annonc.2020.06.015
death, ↓45.8%, p=1.00
Androgen deprivation and SARS-CoV-2 in men with prostate cancer
Details   Retrospective 352 prostate cancer patients in Finland, showing no significant differences in COVID-19 with ADT.
May 21
2020
N/A Wambier et al., Journal of the American Academy of Dermatology, doi:10.1016/j.jaad.2020.05.079 Androgenetic alopecia present in the majority of patients hospitalized with COVID-19: The “Gabrin sign”
Details   Analysis of 175 patients hospitalized with severe COVID-19, showing androgenetic alopecia (AGA) in 42% of women and 79% of men. Authors hypothesize that COVID-19 severity is androgen-mediated, and recommend study of antiandrogen treatments.
May 6
2020
PrEPPEP Montopoli et al., Annals of Oncology, doi:10.1016/j.annonc.2020.04.479
death, ↓95.4%, p=0.15
Androgen-deprivation therapies for prostate cancer and risk of infection by SARS-CoV-2: a population-based study (N = 4532)
Details   Retrospective 5,273 prostate cancer patients on androgen-deprivation therapy (ADT), and 37,161 not on ADT, showing lower risk of cases with treatment.
Please send us corrections, updates, or comments. Vaccines and treatments are both valuable and complementary. All practical, effective, and safe means should be used. No treatment, vaccine, or intervention is 100% available and effective for all current and future variants. Denying the efficacy of any method increases mortality, morbidity, collateral damage, and the risk of endemic status. 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. FLCCC and WCH provide treatment protocols.
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