Randomized Controlled Trials of Early Ambulatory Hydroxychloroquine in the Prevention of COVID-19 Infection, Hospitalization, and Death: Meta-Analysis

9/30 PrEP, PEP, Early

Ladapo et al., medRxiv, doi:10.1101/2020.09.30.20204693 (Preprint) (meta analysis)
Randomized Controlled Trials of Early Ambulatory Hydroxychloroquine in the Prevention of COVID-19 Infection, Hospitalization, and Death: Meta-Analysis

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Meta analysis of prophylactic and early treatment RCTs, 24% reduction in cases, hospitalization or death with HCQ, RR 0.76, p=0.025. No serious adverse cardiac events were reported. 5,577 patients.

The Boulware study provides a breakdown for treatment delay. For the case of < ~4 days (2 days enrollment, ~46 hours shipping), the result of the meta analysis becomes RR 0.68, p=0.0097.

The actual effect may be larger due to treatment delays, followup loss, protocol deviation, active placebos, no severity analysis for cases, and suboptimal regimens.

For the individual studies see [1, 2, 3, 4, 5].

Ladapo et al., 9/30/2020, preprint, 4 authors.

risk of combined cases/death/hospitalization, 24.0% lower, RR 0.76, p = 0.03.

Effect extraction follows pre-specified rules prioritizing more serious outcomes. For an individual study the most serious outcome may have a smaller number of events and lower statistical signficance, however this provides the strongest evidence for the most serious outcomes when combining the results of many trials.

[1] c19study.com/boulware.html

[2] c19study.com/mitjapep.html

[3] c19study.com/rajasingham.html

[4] c19study.com/skipper.html

[5] c19study.com/mitja.html

All 344 studies Meta Analysis

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