Kiselev O I, Maleev V V, Deeva E G, Leneva I A, Selkova E P, Osipova E A, Obukhov A A, Nadorov S A, Kulikova E V
Research Institute of Influenza, Ministry of Health of Russia, Saint-Petersburg, Russia.
Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Welfare, Moscow, Russia.
Ter Arkh. 2015;87(1):88-96. doi: 10.17116/terarkh201587188-96.
To evaluate the efficacy and safety of Arbidol (umifenovir) in adult patients with influenza.
The analysis of the preliminary results of the multicenter double-blind randomized placebo-controlled post-marketing study ARBITR was performed. A total of 293 adults aged 18 to 65 years with influenza or acute respiratory tract infection of no more than 36 hours' duration were enrolled in the study. Individuals were randomized into 2 treatment groups: oral umifenovir 200 mg four times daily for 5 days or placebo four times daily for 5 days. The efficacy endpoints were time to resolution of all symptoms, severity of symptoms and illness, durations of virus shedding.
The efficacy of umifenovir was evaluated in the group of 119 (40.6%) patients with influenza: 45 patients with laboratory-confirmed influenza and 74 patients whom diagnosis of influenza was made based on clinical and epidemiological data. Umifenovir had influence on the time to resolution of all symptoms. All symptoms were resolved within the first 60 hours after therapy initiation in 23.8% patients with laboratory-confirmed influenza in the umifenovir group and it was 5.7 times greater compared to placebo group (4.2%) (p < 0.05). Severity of illness, catarrhal symptoms and intoxication was reduced with umifenovir compared to placebo, reducing of severity was most evidently observed within the first 2-3 days following the therapy initiation. Umifenovir had a significant effect on viral shedding. The proportion of patients still shedding influenza virus on day 4 was significantly reduced in the umifenovir group compared to placebo (25 vs 53%, respectively; p < 0.05).
It was found that the effect of umifenovir in the treatment of influenza in adults is most pronounced in the acute stage of the disease and appears in the reduction of time to resolution of all symptoms of the disease, reducing the severity of symptoms of the disease and durations of virus shedding.
评估阿比朵尔(乌米芬诺)治疗成人流感的疗效和安全性。
对多中心双盲随机安慰剂对照上市后研究ARBITR的初步结果进行分析。共纳入293例年龄在18至65岁之间、患有流感或急性呼吸道感染且病程不超过36小时的成年人。将个体随机分为2个治疗组:口服乌米芬诺200mg,每日4次,共5天;或安慰剂,每日4次,共5天。疗效终点为所有症状消退时间、症状和疾病严重程度、病毒排毒持续时间。
在119例(40.6%)流感患者组中评估了乌米芬诺的疗效:45例实验室确诊流感患者和74例根据临床和流行病学数据诊断为流感的患者。乌米芬诺对所有症状的消退时间有影响。在乌米芬诺组中,23.8%实验室确诊流感患者在治疗开始后的前60小时内所有症状均消退,这比安慰剂组(4.2%)高5.7倍(p<0.05)。与安慰剂相比,乌米芬诺降低了疾病严重程度、卡他症状和中毒症状,在治疗开始后的前2至3天内,严重程度降低最为明显。乌米芬诺对病毒排毒有显著影响。与安慰剂相比,乌米芬诺组在第4天仍有流感病毒排毒的患者比例显著降低(分别为25%和53%;p<0.05)。
发现乌米芬诺治疗成人流感的效果在疾病急性期最为显著,表现为缩短疾病所有症状的消退时间、降低疾病症状严重程度以及缩短病毒排毒持续时间。