法维拉韦与其他抗病毒药物或 COVID-19 治疗标准药物的比较：一项快速系统评价和荟萃分析。
Favipiravir versus other antiviral or standard of care for COVID-19 treatment: a rapid systematic review and meta-analysis.
机构信息
Department of Emergency Medicine, Mangalbare Hospital, Morang, Nepal.
Dr Iwamura Memorial Hospital, Bhaktapur, Nepal.
出版信息
Virol J. 2020 Sep 24;17(1):141. doi: 10.1186/s12985-020-01412-z.
BACKGROUND
The COVID-19 causing coronavirus is an enveloped RNA virus that utilizes an enzyme RNA dependent RNA polymerase for its replication. Favipiravir (FVP) triphosphate, a purine nucleoside analog, inhibits that enzyme. We have conducted this systematic review and meta-analysis on efficacy and safety of the drug FVP as a treatment for COVID-19.
METHODS
Databases like Pubmed, Pubmed Central, Scopus, Embase, Google Scholar, preprint sites, and clinicaltirals.gov were searched. The studies with the standard of care (SOC) and FVP as a treatment drug were considered as the treatment group and the SOC with other antivirals and supportive care as the control group. Quantitative synthesis was done using RevMan 5.4. Clinical improvement, negative conversion of reverse transcription-polymerase chain reaction (RT-PCR), adverse effects, and oxygen requirements were studied.
RESULTS
We identified a total of 1798 studies after searching the electronic databases. Nine in the qualitative studies and four studies in the quantitative synthesis met the criteria. There was a significant clinical improvement in the FVP group on the 14th day compared to the control group (RR 1.29, 1.08-1.54). Clinical deterioration rates were less likely in the FVP group though statistically not significant (OR 0.59, 95% CI 0.30-1.14) at the endpoint of study (7-15 days). The meta-analysis showed no significant differences between the two groups on viral clearance (day 14: RR 1.06, 95% CI 0.84-1.33), non-invasive ventilation or oxygen requirement (OR 0.76, 95% CI 0.42-1.39), and adverse effects (OR 0.69, 0.13-3.57). There are 31 randomized controlled trials (RCTs) registered in different parts of the world focusing FVP for COVID-19 treatment.
CONCLUSION
There is a significant clinical and radiological improvement following treatment with FVP in comparison to the standard of care with no significant differences on viral clearance, oxygen support requirement and side effect profiles.
背景
导致 COVID-19 的冠状病毒是一种包膜 RNA 病毒，利用依赖 RNA 的 RNA 聚合酶进行复制。法匹拉韦（FVP）三磷酸是一种嘌呤核苷类似物，可抑制该酶。我们对该药物 FVP 治疗 COVID-19 的疗效和安全性进行了系统评价和荟萃分析。
方法
检索了 Pubmed、Pubmed Central、Scopus、Embase、Google Scholar、预印本网站和 clinicaltirals.gov 等数据库。将以标准治疗（SOC）和 FVP 作为治疗药物的研究作为治疗组，将 SOC 与其他抗病毒药物和支持性治疗作为对照组。使用 RevMan 5.4 进行定量合成。研究了临床改善、逆转录-聚合酶链反应（RT-PCR）的阴性转换、不良反应和氧气需求。
结果
我们在电子数据库中搜索后共发现 1798 项研究。9 项定性研究和 4 项定量合成研究符合标准。与对照组相比，FVP 组在第 14 天的临床改善更为显著（RR 1.29，1.08-1.54）。尽管在研究终点（第 7-15 天），FVP 组的临床恶化率较低，但无统计学意义（OR 0.59，95%CI 0.30-1.14）。荟萃分析显示，两组在病毒清除方面无显著差异（第 14 天：RR 1.06，95%CI 0.84-1.33），在无创通气或氧气需求方面无显著差异（OR 0.76，95%CI 0.42-1.39），在不良反应方面无显著差异（OR 0.69，0.13-3.57）。目前，全世界已有 31 项 RCT 注册，聚焦 FVP 治疗 COVID-19。
结论
与标准治疗相比，FVP 治疗可显著改善临床和影像学结果，在病毒清除率、氧气支持需求和不良反应谱方面无显著差异。
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