Covid-19 living Data

Pharmacologic treatments for covid-19 patients

Sofosbuvir/ledipasvir vs Standard care

This comparison will not be updated. Last search date 14 Dec, 2022.

Outpatients

Forest plots
(last update: 2022-08-18)

Hospitalized patients

Forest plots
(last update: 2022-05-16)

Summary of findings
(last update: 2022-09-27)

Patient or population: COVID-19 patients
Setting: Worldwide
Intervention: Sofosbuvir/ledipasvir
Comparison: Standard care

Outcome	Relative effect (95% CI)	Absolute effect (95% CI)¹		Certainty of the Evidence (GRADE)
Clinical improvement D28	RR: 1.03 (0.85 - 1.24)	25 more per 1000 (from 123 fewer to 197 more)		Very low certainty Reasons to downgrade Risk of bias: Serious Risk of bias downgraded by 1 level: some concerns regarding deviation from intended intervention, outcome measurement and selection of the reported results Inconsistency: Not serious Indirectness: Serious single study from a single institution therefore results in this population might not be generalizable to other settings Imprecision: Very serious due to very wide confidence interval consistent with the possibility for benefit and the possibility for harm
1 trials Nourian A, 2020 90 participants		Sofosbuvir/ledipasvir 847 per 1,000 (699 - 1000)	Standard care 822 per 1,000
Clinical improvement D60	Outcome not yet measured or reported
WHO progression score (level 7 or above) D28	Outcome not yet measured or reported
WHO progression score (level 7 or above) D60	Outcome not yet measured or reported
All-cause mortality D28	RR: 0.37 (0.03 - 4.30)	33 fewer per 1000 (from 51 fewer to 175 more)		Very low certainty Reasons to downgrade Risk of bias: Serious Risk of bias downgraded by 1 level: some concerns regarding deviations from intended intervention and selection of reported results Inconsistency: Serious Inconsistency downgraded by 1 level: I²=:58% Indirectness: Not serious Imprecision: Very serious due to very wide confidence interval consistent with the possibility for benefit and the possibility for harm
2 trials Nourian A, 2020; Elgohary M, 2022 340 participants		Sofosbuvir/ledipasvir 20 per 1,000 (2 - 228)	Standard care 53 per 1,000
All-cause mortality D60	Outcome not yet measured or reported
Viral negative conversion D7	Outcome not yet measured or reported
Adverse events	Outcome not yet measured or reported
Serious adverse events	Outcome not yet measured or reported

¹The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI)

CI: Confidence interval; RR: Risk ratio

GRADE Working Group grades of evidence
High certainty: We are very confident that the true effect lies close to that of the estimate of the effect
Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different
Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect
Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect

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Permanent URL for this comparison: https://covid-nma.com/living_data/index.php?comparison=243

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Trial	Funding	Comparisons		Design	Participants	Sample size	Overall risk of bias Highest assessment	Full description
		Treatment 1	Treatment 2
NCT04498936 Medhat M, Arab J Gastroenterol, 2022 Full text Commentary	Public/non profit	Sofosbuvir/ledipasvir Nitazoxanide Sofosbuvir/ledipasvir	Standard care Standard care Nitazoxanide	RCT	Outpatients and isolated patients with confirmed COVID-19 (mild-moderate) treated at 3 centers in Egypt.	N=220	Some concerns Details	Full description
NCT04530422 Elgohary M, J Med Life, 2022 Full text Full text Commentary Commentary Commentary	Not reported/unclear	Sofosbuvir+Ledipasvir	Standard care	RCT	Patients with confirmed COVID-19 (moderate) admitted to a single center in Egypt	N=250	Some concerns Details	Full description
IRCT20100228003449N29 Nourian A, Acta Biomed, 2020 Full text Commentary	Mixed	Sofosbuvir-ledipasvir	Standard care	RCT	Patients with suspected or confirmed COVID-19 (mild-severe) admitted to a single center in Iran	N=90	Some concerns Details	Full description