Evidence map›Paper›PMID 34363189›Full record

ArticleInfectious diseases and therapy2021

Early Start of Oral Clarithromycin Is Associated with Better Outcome in COVID-19 of Moderate Severity: The ACHIEVE Open-Label Single-Arm Trial.

Konstantinos Tsiakos, Antonios Tsakiris, Georgios Tsibris, Pantazis-Michael Voutsinas, Periklis Panagopoulos, Maria Kosmidou, Vasileios Petrakis, Areti Gravvani, Theologia Gkavogianni, Eleftherios Klouras and 21 more

Registry-linked trialOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Infectious diseases and therapy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04398004 (Anti-inflammatory Clarithromycin to Improve SARS-CoV-2), which is not on this map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
1.2field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04398004 phase2completednot on this map

Anti-inflammatory Clarithromycin to Improve SARS-CoV-2 (COVID-19) Infection Early: The ACHIEVE Open-label Non-randomized Clinical Trial

TypeinterventionalSponsorHellenic Institute for the Study of SepsisRan2020 to 2020Enrolled90ConditionsCOVID-19, Virus Diseases, Corona Virus InfectionArmsClarithromycin
3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 22 citations in OpenAlex.

  1. Review
  2. Article
  3. Observational
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  8. Beneficial ex vivo immunomodulatory and clinical effects of clarithromycin in COVID-19.Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy · 2022
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

31 authors at 5 institutions in 1 country.

Konstantinos Tsiakos3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, 115 27, Athens, Greece.
Antonios Tsakiris *4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, ATTIKON University General Hospital, 1 Rimini Street, 124 62, Athens, Greece.
Georgios Tsibris *4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, ATTIKON University General Hospital, 1 Rimini Street, 124 62, Athens, Greece.
Pantazis-Michael Voutsinas *4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, ATTIKON University General Hospital, 1 Rimini Street, 124 62, Athens, Greece.
Periklis Panagopoulos2nd Department of Internal Medicine, Medical School, Democritus University of Thrace, 681 00, Alexandroupolis, Greece.
Maria Kosmidou1st Department of Internal Medicine, School of Health Sciences, Faculty of Medicine, University of Ioannina, 455 00, Ioannina, Greece.
Vasileios Petrakis2nd Department of Internal Medicine, Medical School, Democritus University of Thrace, 681 00, Alexandroupolis, Greece.
Areti Gravvani3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, 115 27, Athens, Greece.
Theologia Gkavogianni4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, ATTIKON University General Hospital, 1 Rimini Street, 124 62, Athens, Greece.
Eleftherios Klouras1st Department of Internal Medicine, School of Health Sciences, Faculty of Medicine, University of Ioannina, 455 00, Ioannina, Greece.
Konstantina Katrini4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, ATTIKON University General Hospital, 1 Rimini Street, 124 62, Athens, Greece.
Panagiotis Koufargyris4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, ATTIKON University General Hospital, 1 Rimini Street, 124 62, Athens, Greece.
Iro Rapti1st Department of Internal Medicine, School of Health Sciences, Faculty of Medicine, University of Ioannina, 455 00, Ioannina, Greece.
Athanassios Karageorgos4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, ATTIKON University General Hospital, 1 Rimini Street, 124 62, Athens, Greece.
Emmanouil Vrentzos4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, ATTIKON University General Hospital, 1 Rimini Street, 124 62, Athens, Greece.
Christina Damoulari4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, ATTIKON University General Hospital, 1 Rimini Street, 124 62, Athens, Greece.
Vagia Zarkada4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, ATTIKON University General Hospital, 1 Rimini Street, 124 62, Athens, Greece.
Chrysanthi Sidiropoulou2nd Department of Internal Medicine, Tzaneion General Hospital of Piraeus, Piraeus, Greece.
Sofia Artemi4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, ATTIKON University General Hospital, 1 Rimini Street, 124 62, Athens, Greece.
Anastasios IoannidisDepartment of Nursing, Faculty of Health Sciences, University of Peloponnese, Tripoli, Greece.
Androniki Papapostolou4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, ATTIKON University General Hospital, 1 Rimini Street, 124 62, Athens, Greece.
Evangelos Michelakis4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, ATTIKON University General Hospital, 1 Rimini Street, 124 62, Athens, Greece.
Maria Georgiopoulou4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, ATTIKON University General Hospital, 1 Rimini Street, 124 62, Athens, Greece.
Dimitra-Melia Myrodia3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, 115 27, Athens, Greece.
Panteleimon Tsiamalos2nd Department of Internal Medicine, Tzaneion General Hospital of Piraeus, Piraeus, Greece.
Konstantinos Syrigos3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, 115 27, Athens, Greece.
George Chrysos2nd Department of Internal Medicine, Tzaneion General Hospital of Piraeus, Piraeus, Greece.
Thomas Nitsotolis3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, 115 27, Athens, Greece.
Haralampos Milionis1st Department of Internal Medicine, School of Health Sciences, Faculty of Medicine, University of Ioannina, 455 00, Ioannina, Greece.
Garyphallia Poulakou3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, 115 27, Athens, Greece.
Evangelos J Giamarellos-Bourboulis4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, ATTIKON University General Hospital, 1 Rimini Street, 124 62, Athens, Greece. egiamarel@med.uoa.gr.ORCID http://orcid.org/0000-0003-4713-3911
National and Kapodistrian University of Athens · GRUniversity of Ioannina · GRTzaneion General Hospital · GRDemocritus University of Thrace · GRUniversity of Peloponnese · GR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe anti-inflammatory effect of macrolides prompted the study of oral clarithromycin in moderate COVID-19.

methodsAn open-label non-randomized trial in 90 patients with COVID-19 of moderate severity was conducted between May and October 2020. The primary endpoint was defined at the end of treatment (EOT) as no need for hospital re-admission and no progression into lower respiratory tract infection (LRTI) for patients with upper respiratory tract infection and as at least 50% decrease of the respiratory symptoms score without progression into severe respiratory failure (SRF) for patients with LRTI. Viral load, biomarkers, the function of mononuclear cells and safety were assessed.

resultsThe primary endpoint was attained in 86.7% of patients treated with clarithromycin (95% CIs 78.1-92.2%); this was 91.7% and 81.4% among patients starting clarithromycin the first 5 days from symptoms onset or later (odds ratio after multivariate analysis 6.62; p 0.030). The responses were better for patients infected by non-B1.1 variants. Clarithromycin use was associated with decreases in circulating C-reactive protein, tumour necrosis factor-alpha and interleukin (IL)-6; by increase of production of interferon-gamma and decrease of production of interleukin-6 by mononuclear cells; and by suppression of SARS-CoV-2 viral load. No safety concerns were reported.

conclusionsEarly clarithromycin treatment provides most of the clinical improvement in moderate COVID-19.

trial registrationClinicalTrials.gov, NCT04398004.

Indexed as

ClarithromycinCOVID-19Th1Th2Viral load

Identifiers

PMID34363189
PMCPMC8345236
OpenAlexW3190088329

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.