Home > Journals > Minerva Medica > Past Issues > Articles online first > Minerva Medica 2023 May 19

CURRENT ISSUE
 

JOURNAL TOOLS

Publishing options
eTOC
To subscribe
Submit an article
Recommend to your librarian
 

ARTICLE TOOLS

Publication history
Reprints
Permissions
Cite this article as
Share

 

REVIEW   

Minerva Medica 2023 May 19

DOI: 10.23736/S0026-4806.23.08538-5

Copyright © 2023 EDIZIONI MINERVA MEDICA

language: English

Antiandrogen agents in COVID-19: a meta-analysis of randomized trials

Yuki KOTANI 1, 2, 3, Giovanni LANDONI 1, 2 , Tommaso SCQUIZZATO 1, Nadia MOHAMED 1, Martina BAIARDO REDAELLI 1, Rosaria SOFIA 1, Stefano FRESILLI 1, Alberto ZANGRILLO 1, 2, Maria L. AZZOLINI 1

1 Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy; 2 School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; 3 Department of Intensive Care Medicine, Kameda Medical Center, Kamogawa, Japan



INTRODUCTION: Antiandrogen therapy can reduce the expression of transmembrane protease 2, which is essential for severe acute respiratory syndrome coronavirus-2 to enter the host cells. Prior trials suggested the efficacy of antiandrogen agents in patients with COVID-19. We investigated whether antiandrogen agents reduce mortality compared to placebo or usual care.
EVIDENCE ACQUISITION: We searched for randomized controlled trials comparing antiandrogen agents with placebo or usual care alone in adults with COVID-19 in PubMed, EMBASE, the Cochrane Library, the reference lists of retrieved articles, and publications by manufacturers of antiandrogen agents. The primary outcome was mortality at the longest follow-up available. The secondary outcomes included clinical worsening, the need for invasive mechanical ventilation, admission to the intensive care unit, hospitalization, and thrombotic events. We registered this systematic review and meta-analysis in PROSPERO International Prospective Register of Systematic Reviews (CRD42022338099).
EVIDENCE SYNTHESIS: We included 13 randomized controlled trials enrolling 1934 COVID-19 patients. We found that antiandrogen agents reduced mortality at the longest follow-up available (91/1021 [8.9%] vs. 245/913 [27%]; risk ratio =0.40; 95% confidence interval, 0.25-0.65; P=0.0002; I2=54%). Antiandrogen therapy also reduced clinical worsening (127/1016 [13%] vs. 298/911 [33%]; risk ratio =0.44; 95% confidence interval, 0.27-0.71; P=0.0007; I2=70%) and hospitalization (97/160 [4.4%] vs. 24/165 [15%]; risk ratio =0.24; 95% confidence interval, 0.10-0.58; P=0.002; I2=44%). There was no significant difference in the other outcomes between the two treatment groups.
CONCLUSIONS: Antiandrogen therapy reduced mortality and clinical worsening in adult patients with COVID-19.


KEY WORDS: Systematic review; Meta-analysis; Androgen antagonists; COVID-19; Mortality

top of page