Evidence map›Paper›PMID 40925930›Full record

Trial reportEuropean journal of clinical pharmacology2025

Efficacy and safety of nitazoxanide and escitalopram as adjuvant therapies in patients with rheumatoid arthritis: a randomized controlled study.

Tarek M Mostafa, Abeer A El-Sayed, Abdel Moaty A Afifi, Dalia R El-Afify

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in European journal of clinical pharmacology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

4 authors.

Tarek M MostafaDepartment of Clinical Pharmacy, Faculty of Pharmacy, Tanta University, Tanta, Egypt.ORCID http://orcid.org/0000-0003-1071-5416
Abeer A El-SayedDepartment of Pharmacy Practice, Faculty of Pharmacy, Arish Branch, Sinai University, Arish, Egypt. abeer.elsayed@su.edu.eg.ORCID http://orcid.org/0000-0002-6787-2087
Abdel Moaty A AfifiDepartment of Physical Medicine, Faculty of Medicine, Rheumatology & Rehabilitation, Mansoura University, Mansoura, Egypt.ORCID http://orcid.org/0000-0002-4132-3530
Dalia R El-AfifyDepartment of Clinical Pharmacy, Faculty of Pharmacy, Tanta University, Tanta, Egypt.ORCID http://orcid.org/0000-0002-1454-4637

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThis research aimed at evaluating the effectiveness and safety of nitazoxanide and escitalopram as adjuvant therapies in patients with rheumatoid arthritis (RA).

methodsIn this randomized controlled parallel study, 90 patients with active RA were randomized into three groups; group 1 (control group; n = 30) which received traditional therapy, group 2 (Nitazoxanide group; n = 30) which received traditional therapy plus 1 gm/day oral nitazoxanide, and group 3 (Escitalopram group; n = 30) which received traditional therapy plus 10 mg/day oral escitalopram for three months. At baseline and 3 months after treatment, clinical and functional assessments were done through the 28-joint count disease activity score using C-reactive protein (DAS28-CRP), the health assessment questionnaire-disability index (HAQ-DI), and the patient's global assessment (PGA). Also, serum levels of high-sensitivity C-reactive protein (hs-CRP), signal transducer and activator of transcription-3 (STAT-3), Janus kinase-2 (JAK-2), toll-like receptors 4 (TLR-4), interleukin-1 beta (IL-1β), and malondialdehyde (MDA) were assessed. Data were analyzed using paired t-test and one-way analysis of variance, followed by Tukey's HDS test.

resultsThree months after treatment and as compared to the control group, the nitazoxanide group showed a significant decline in PGA (P = 0.042), and serum levels of STAT-3 (P < 0.001), JAK-2 (P < 0.001), TLR-4 (P < 0.001), and IL-1β (P < 0.001). On the other hand, the escitalopram group produced a significant decrease in DAS28-CRP score (P = 0.029), HAQ-DI score (P = 0.001), and serum levels of JAK-2 (P = 0.001), TLR-4 (P < 0.001), IL-1β (P < 0.001), and MDA (P < 0.001). As compared to nitazoxanide group, the escitalopram group produced a significant decline in fatigue score (P < 0.001) and serum levels of both IL-1β (P = 0.023) and MDA (P < 0.001). Both medications were safe; however, chromaturia was the only significant nitazoxanide-related adverse effect.

conclusionNitazoxanide and escitalopram could serve as potential adjuvant therapies for patients with RA based on their effectiveness and safety data.

Indexed as

Antirheumatic AgentsArthritis, RheumatoidCitalopramThiazolesAdultAgedC-Reactive ProteinDrug Therapy, CombinationFemaleHumansMaleMiddle AgedNitro CompoundsTreatment OutcomeAntirheumatic AgentsCitalopramC-Reactive ProteinnitazoxanideNitro CompoundsThiazolesEscitalopramIL-1βJAK-2NitazoxanideRheumatoid arthritisSTAT-3TLR-4

Identifiers

PMID40925930
PMCPMC12680779

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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 Socratic graph.