Covid-19 living Data

Pharmacologic treatments for covid-19 patients

Sofosbuvir/daclatasvir vs Standard care/Placebo

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

Hospitalized patients

Forest plots
(last update: 2022-10-07)

Summary of findings
(last update: 2022-10-13)

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

Outcome	Relative effect (95% CI)	Absolute effect (95% CI)¹		Certainty of the Evidence (GRADE)
Clinical improvement D28	RR: 1.06 (0.93 - 1.21)	46 more per 1000 (from 53 fewer to 160 more)		Very low certainty Reasons to downgrade Risk of bias: Not serious Inconsistency: Serious Inconsistency downgraded by 1 level: I²=:53.2% 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 Mobarak S, 2021; Yakoot M, 2022 1172 participants		Sofosbuvir/daclatasvir 805 per 1,000 (707 - 919)	Standard care/Placebo 760 per 1,000
Clinical improvement D60	Outcome not yet measured or reported
WHO progression score (level 7 or above) D28	RR: 0.41 (0.08 - 2.00)	66 fewer per 1000 (from 102 fewer to 111 more)		Very low certainty Reasons to downgrade Risk of bias: Serious Risk of bias downgraded by 1 level: some concerns regarding deviations from intended interventions and missing data. Inconsistency: Not serious Indirectness: Serious Indirectness downgraded by 1 level: 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 Yakoot M, 2022 89 participants		Sofosbuvir/daclatasvir 46 per 1,000 (9 - 222)	Standard care/Placebo 111 per 1,000
WHO progression score (level 7 or above) D60	Outcome not yet measured or reported
All-cause mortality D28	RR: 0.74 (0.37 - 1.45)	31 fewer per 1000 (from 74 fewer to 53 more)		Very low certainty Reasons to downgrade Risk of bias: Serious Risk of bias downgraded by 1 level: some concerns regarding adequate randomization, deviation from intended intervention, missing data and selection of the reported results Inconsistency: Not serious Indirectness: Not serious Imprecision: Very serious due to very wide confidence interval consistent with the possibility for benefit and the possibility for harm
4 trials Sadeghi A, 2020; Yakoot M, 2022; Mobarak S, 2021; Abbass S, 2021 1322 participants		Sofosbuvir/daclatasvir 87 per 1,000 (44 - 171)	Standard care/Placebo 118 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	RR: 0.25 (0.08 - 0.82)	225 fewer per 1000 (from 276 fewer to 54 fewer)		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: Not serious We presume that the adverse event rates and the corresponding relative risks, are similar across diverse settings, therefore not downgraded for indirectness Imprecision: Serious due to low number of participants/events
1 trials Abbass S, 2021 80 participants		Sofosbuvir/daclatasvir 75 per 1,000 (24 - 246)	Standard care/Placebo 300 per 1,000
Serious adverse events	RR: *	Zero events in both groups		Very low certainty Reasons to downgrade Risk of bias: Serious Risk of bias downgraded by 1 level: some concerns regarding adequate randomization, deviation from intended intervention, missing data and outcome measurement Inconsistency: Not serious Indirectness: Not serious Imprecision: Very serious no events in both groups
2 trials Yakoot M, 2022; Sadenghi A, 2020 159 participants		Sofosbuvir/daclatasvir 0 per 1,000 (* - *)	Standard care/Placebo 0 per 1,000

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=58

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Trial	Funding	Comparisons		Design	Participants	Sample size	Overall risk of bias Highest assessment	Full description
		Treatment 1	Treatment 2
DRKS00022203 Yakoot M, medRxiv, 2022 Full text Commentary Commentary	Private	Sofosbuvir+Daclatasvir	Standard care	RCT	Patients with confirmed COVID-19 (mild-severe) admitted to a single center in Egypt.	N=89	Some concerns Details	Full description
ISRCTN21085622 Abbass S, J Med Virol, 2021 Full text Commentary	Private	Sofosbuvir+Daclatasvir Sofosbuvir + Ravidasvir Sofosbuvir+Daclatasvir	Standard care Standard care Sofosbuvir + Ravidasvir	RCT	Patients with confirmed COVID-19 (moderate-severe) admitted to 4 centers in Egypt	N=120	Some concerns Details	Full description
IRCT20200624047908N1 DISCOVER Mobarak S, J Antimicrob Chemoth, 2021 Full text Full text Commentary	Public/non profit	Sofosbuvir-Daclatasvir	Placebo	RCT	Patients with suspected or confirmed COVID-19 (moderate-severe) admitted to 19 centers in Iran	N=1083	Some concerns Details	Full description
IRCT20200403046926N1 Roozbeh F, J Antimicrob Chemoth, 2020 Full text Commentary	Public/non profit	Sofosbuvir-Daclatasvir	Standard care	RCT	Outpatients with COVID-19 (mild) treated at a single center in Iran	N=60	N/A	Full description
IRCT20200128046294N2 Sadeghi A, J Antimicrob Chemoth, 2020 Full text Commentary	Mixed	Sofosbuvir-Daclatasvir	Standard care	RCT	Patients with confirmed COVID-19 (moderate-severe) admitted to 4 centers in Iran	N=70	Some concerns Details	Full description