Antiandrogens as Therapies for COVID-19: A Systematic Review

January 2024 in “ Cancers ”

Massimiliano Cani, Samantha Epistolio, Giulia Dazio, Mikol Modesti, Giuseppe Salfi, Martino Pedrani, Luca Isella, Silke Gillessen, Ursula Vogl, Luigi Tortola, Giorgio Treglia, Consuelo Buttigliero, Milo Frattini, Ricardo Pereira Mestre

antiandrogens SARS-CoV-2

Studysummary This systematic review found that antiandrogens do not appear to protect against SARS-CoV-2 infection or reduce COVID-19 severity, suggesting their use is not advisable for COVID-19 treatment. Our plain-language summary of this paper — not a Tressless recommendation.

This systematic review analyzed 31 studies to assess the role of antiandrogens in COVID-19 treatment, focusing on androgen deprivation therapies (ADTs) and their impact on SARS-CoV-2 infection outcomes. The review found that antiandrogens do not appear to protect against SARS-CoV-2 infection or reduce the severity of COVID-19. While some in vitro studies showed promising results, the clinical efficacy of these treatments remains uncertain, with mixed results from various studies. The review emphasizes the need for further research to clarify the potential benefits of hormone deprivation treatments in managing COVID-19, given the complex interplay between androgens, ACE2, and TMPRSS2 in viral entry. Overall, the current evidence does not support the use of antiandrogens for COVID-19 prevention or treatment.

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research 5-Alpha Reductase Inhibitors Use in Prostatic Disease and Beyond

March 2023 in “Translational Andrology and Urology”

This review discusses the pharmacology of 5-alpha reductase inhibitors, their expanding clinical indications beyond benign prostatic hyperplasia, and notes unresolved claims about their potential role in SARS-CoV-2.

Final Results of a Randomized, Placebo-Controlled, Two-Arm, Parallel Clinical Trial of Proxalutamide for Hospitalized COVID-19 Patients: A Multiregional, Joint Analysis of the Proxa-Rescue AndroCoV Trial

research Final Results of a Randomized, Placebo-Controlled, Two-Arm, Parallel Clinical Trial of Proxalutamide for Hospitalized COVID-19 Patients: A Multiregional, Joint Analysis of the Proxa-Rescue AndroCoV Trial

19 citations , December 2021 in “Cureus”

This study found that proxalutamide significantly increased recovery rates, reduced mortality, and shortened hospital stays in hospitalized COVID-19 patients across different regions in Brazil.

research Impact of Androgen Deprivation Therapy on Mortality of Prostate Cancer Patients with COVID-19: A Propensity Score-Based Analysis

9 citations , November 2021 in “Infectious Agents and Cancer”

This study found that the active use of androgen deprivation therapy was not associated with a reduced risk of death in prostate cancer patients with COVID-19.

Proxalutamide Reduces the Rate of Hospitalization for COVID-19 Male Outpatients: A Randomized Double-Blinded Placebo-Controlled Trial

research Proxalutamide Reduces the Rate of Hospitalization for COVID-19 Male Outpatients: A Randomized Double-Blinded Placebo-Controlled Trial

42 citations , July 2021 in “Frontiers in Medicine”

In this study, proxalutamide significantly reduced the 30-day hospitalization rate by 91% compared to placebo in men with COVID-19 treated in outpatient settings.

research The Antiandrogen Enzalutamide Downregulates TMPRSS2 and Reduces Cellular Entry of SARS-CoV-2 in Human Lung Cells

50 citations , July 2021 in “Nature Communications”

This study found that the antiandrogen drug enzalutamide reduced TMPRSS2 levels and significantly decreased SARS-CoV-2 entry and infection in lung cells, supporting further clinical trials for COVID-19 treatment.

Finasteride in Hospitalized Adult Males with COVID-19: A Risk Factor for Severity or an Adjunct Treatment - A Randomized Controlled Clinical Trial

research Finasteride in Hospitalized Adult Males with COVID-19: A Risk Factor for Severity or an Adjunct Treatment - A Randomized Controlled Clinical Trial

8 citations , April 2021 in “Medical journal of the Islamic Republic of Iran”

This study found that a short course of finasteride improved oxygen saturation but had no significant impact on mortality rate or length of hospital stay in older male COVID-19 pneumonia patients.

research The Clinical Applications of Five-Alpha Reductase Inhibitors

2 citations , April 2021 in “Canadian Journal of Urology”

This review summarizes existing studies on 5-alpha reductase inhibitors, noting their effectiveness in reducing prostate volume and cancer risk but highlighting an increased risk of higher grade prostate cancer.

Proxalutamide Significantly Accelerates Viral Clearance and Reduces Time to Clinical Remission in Patients with Mild to Moderate COVID-19: Results from a Randomized, Double-Blinded, Placebo-Controlled Trial

research Proxalutamide Significantly Accelerates Viral Clearance and Reduces Time to Clinical Remission in Patients with Mild to Moderate COVID-19: Results from a Randomized, Double-Blinded, Placebo-Controlled Trial

41 citations , February 2021 in “Cureus”

In this study, Proxalutamide significantly increased the rate of viral clearance and reduced clinical remission time in patients with mild to moderate COVID-19 compared to placebo.

Early Antiandrogen Therapy With Dutasteride Reduces Viral Shedding, Inflammatory Responses, and Time-to-Remission in Males With COVID-19: A Randomized, Double-Blind, Placebo-Controlled Interventional Trial

research Early Antiandrogen Therapy With Dutasteride Reduces Viral Shedding, Inflammatory Responses, and Time-to-Remission in Males With COVID-19: A Randomized, Double-Blind, Placebo-Controlled Interventional Trial

41 citations , February 2021 in “Cureus”

This study found that in males with mild COVID-19, treatment with dutasteride, along with standard therapy, may reduce viral shedding and inflammation compared to placebo.

research Anti-Androgens May Protect Against Severe COVID-19 Outcomes: Results From a Prospective Cohort Study of 77 Hospitalized Men

49 citations , January 2021 in “Journal of The European Academy of Dermatology and Venereology”

Anti-androgens, like finasteride, dutasteride, and spironolactone, may lessen the severity of COVID-19 in men, leading to fewer ICU admissions.

research Androgen Signaling Regulates SARS-CoV-2 Receptor Levels and Is Associated with Severe COVID-19 Symptoms in Men

139 citations , December 2020 in “Cell Stem Cell”

Male hormones affect COVID-19 severity and certain drugs targeting these hormones could help reduce the risk.

research 5-Alpha-Reductase Inhibitors Are Associated With Reduced Frequency of COVID-19 Symptoms in Males With Androgenetic Alopecia

36 citations , November 2020 in “Journal of The European Academy of Dermatology and Venereology”

This study found that 5-alpha-reductase inhibitors were associated with a reduced frequency of COVID-19 symptoms in males with androgenetic alopecia.

A Preliminary Observation: Male Pattern Hair Loss Among Hospitalized COVID-19 Patients in Spain – A Potential Clue to the Role of Androgens in COVID-19 Severity

research A Preliminary Observation: Male Pattern Hair Loss Among Hospitalized COVID-19 Patients in Spain – A Potential Clue to the Role of Androgens in COVID-19 Severity

134 citations , April 2020 in “Journal of Cosmetic Dermatology”

Male pattern hair loss could hint at androgens affecting COVID-19 severity.