SARS-CoV-2 accelerated clearance using a novel nitric oxide nasal spray (NONS) treatment: A randomized trial – The Lancet Regional Health

Figure 1


Examine design

On this multicentre, double-blind, parallel-group efficacy and security examine, symptomatic adults inside three days of signs onset with a constructive fast SARS-CoV-2 antigen check have been randomized to obtain NONS or placebo. Nasal SARS-CoV-2 RNA presence was confirmed by a constructive reverse transcription polymerase chain response (RT-PCR) screening swab check (outcomes weren’t accessible till post-randomization).

Topics self-administered nitric oxide nasal spray or placebo two sprays per nostril; 0·45 mL/dose six instances a day, a minimum of two to a few hours aside whereas awake for seven remedy days (Day one to Day eight [end of treatment (EOT)]). All individuals obtained commonplace supportive care in accordance with newest tips issued by Ministry of Well being and Household Welfare from the Authorities of India, which included antipyretics for the remedy of fever and ache, antitussives for cough, and satisfactory hydration/vitamin.

The protocol obtained approval from every Investigator’s web site Institutional Ethics Committee (IEC). The trial was carried out in accordance with the Good Medical Apply (GCP), ideas of the Declaration of Helsinki, and all relevant nationwide and native regulatory necessities. The trial was initiated with 20 scientific websites throughout India; 15 websites enrolled topics within the examine from 10 August 2021 to 25 January 2022. A low incidence of COVID-19 infections and different precedence research prevented recruitment in 5 websites. A abstract of the important thing protocol amendments primarily based on dialogue with the regulatory authority Drug Controller Common of India (DCGI) is described within the Desk S1 (Supplementary Materials; Appendix).


Eligible grownup women and men (aged 18–70 years) with gentle COVID-19 signs and a constructive nasal fast antigen check for SARS-CoV-2 have been enrolled into the examine no matter their vaccination standing. Gentle signs of COVID-19 included fever, cough, sore throat, malaise, headache, nasal congestion, muscle ache, gastrointestinal signs, lack of style or scent with out shortness of breath or dyspnea. The utmost permitted distinction within the time of onset of signs and the time of remedy was ≤ 72 hours. Blood oxygen saturation (SpO2) > 94 % and respiratory charge < 24 breaths/min have been additionally enrolment criterion.

For girls to be enrolled, proof of post-menopause, or a damaging pre-treatment urine being pregnant check (for pre-menopausal topics) was required. Girls of child-bearing age (feminine or male with feminine companion of child-bearing age) agreed to take efficient contraceptive measures (together with hormonal contraception, barrier strategies or abstinence) along with his/her companion throughout the examine interval and for a minimum of seven days following the EOT. All exclusion standards and prohibited drugs are listed in Desk S2 (Appendix).

Members needed to be able to offering knowledgeable consent, self-administering the nasal spray, and recording scientific indicators indicative of COVID-19 signs as outlined by FDA COVID-19 Steerage Doc.


U.S. Division of Well being and Human Companies Meals and Drug Administration Middle for Drug Analysis and Analysis (CDER) Middle for Biologics Analysis and Analysis (CBER)
Assessing COVID-19-Associated Signs in Outpatient Grownup and Adolescent Topics in Medical Trials of Medicine and Organic Merchandise for COVID-19 Prevention or Therapy Steerage for Business.