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Telmisartan for treatment of Covid-19 patients: An open multicenter randomized clinical trial.替米沙坦治疗新冠肺炎患者：一项开放的多中心随机临床试验。
EClinicalMedicine. 2021 Jun 18;37:100962. doi: 10.1016/j.eclinm.2021.100962. eCollection 2021 Jul.
2
Association of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers With the Risk of Hospitalization and Death in Hypertensive Patients With COVID-19.血管紧张素转换酶抑制剂和血管紧张素受体阻滞剂与 COVID-19 合并高血压患者住院和死亡风险的关系。
J Am Heart Assoc. 2021 Jul 6;10(13):e018086. doi: 10.1161/JAHA.120.018086. Epub 2021 Feb 24.
3
SARS-CoV-2 spike protein promotes IL-6 trans-signaling by activation of angiotensin II receptor signaling in epithelial cells.SARS-CoV-2 刺突蛋白通过激活上皮细胞中的血管紧张素 II 受体信号促进 IL-6 转信号。
PLoS Pathog. 2020 Dec 7;16(12):e1009128. doi: 10.1371/journal.ppat.1009128. eCollection 2020 Dec.
4
Comparison of infection risks and clinical outcomes in patients with and without SARS-CoV-2 lung infection under renin-angiotensin-aldosterone system blockade: Systematic review and meta-analysis.比较肾素-血管紧张素-醛固酮系统阻滞剂治疗下合并和不合并 SARS-CoV-2 肺部感染患者的感染风险和临床结局：系统评价和荟萃分析。
Br J Clin Pharmacol. 2021 Jun;87(6):2475-2492. doi: 10.1111/bcp.14660. Epub 2020 Dec 18.
5
The Plasmatic Aldosterone and C-Reactive Protein Levels, and the Severity of Covid-19: The Dyhor-19 Study.血浆醛固酮和C反应蛋白水平与新型冠状病毒肺炎的严重程度：Dyhor-19研究
J Clin Med. 2020 Jul 21;9(7):2315. doi: 10.3390/jcm9072315.
6
Rationale and design of the PRAETORIAN-COVID trial: A double-blind, placebo-controlled randomized clinical trial with valsartan for PRevention of Acute rEspiraTORy dIstress syndrome in hospitAlized patieNts with SARS-COV-2 Infection Disease.PRAETORIAN-COVID 试验的原理和设计：一项双盲、安慰剂对照随机临床试验，使用缬沙坦预防 SARS-CoV-2 感染疾病住院患者的急性呼吸窘迫综合征。
Am Heart J. 2020 Aug;226:60-68. doi: 10.1016/j.ahj.2020.05.010. Epub 2020 May 21.
7
Estimation of Renin-Angiotensin-Aldosterone-System (RAAS)-Inhibitor effect on COVID-19 outcome: A Meta-analysis.评估肾素-血管紧张素-醛固酮系统（RAAS）抑制剂对 COVID-19 结局的影响：一项荟萃分析。
J Infect. 2020 Aug;81(2):276-281. doi: 10.1016/j.jinf.2020.05.052. Epub 2020 May 28.
8
Decreased Mortality of COVID-19 With Renin-Angiotensin-Aldosterone System Inhibitors Therapy in Patients With Hypertension: A Meta-Analysis.肾素-血管紧张素-醛固酮系统抑制剂治疗高血压患者可降低COVID-19死亡率：一项荟萃分析
Hypertension. 2020 Aug;76(2):e13-e14. doi: 10.1161/HYPERTENSIONAHA.120.15572. Epub 2020 May 27.
9
Pulmonary Vascular Endothelialitis, Thrombosis, and Angiogenesis in Covid-19.新型冠状病毒肺炎的肺血管内皮细胞炎症、血栓形成和血管生成。
N Engl J Med. 2020 Jul 9;383(2):120-128. doi: 10.1056/NEJMoa2015432. Epub 2020 May 21.
10
Telmisartan as tentative angiotensin receptor blocker therapeutic for COVID-19.替米沙坦作为血管紧张素受体阻滞剂治疗 COVID-19 的初步尝试。
Drug Dev Res. 2020 Nov;81(7):768-770. doi: 10.1002/ddr.21679. Epub 2020 May 1.

用于治疗新型冠状病毒肺炎的血管紧张素受体阻滞剂：关于正在进行及未来前瞻性临床试验的病理生理学和药理学考量

Angiotensin Receptor Blockers for COVID-19: Pathophysiological and Pharmacological Considerations About Ongoing and Future Prospective Clinical Trials.

作者信息

Rothlin Rodolfo Pedro, Duarte Mariano, Pelorosso Facundo Germán, Nicolosi Liliana, Salgado M Victoria, Vetulli Héctor Miguel, Spitzer Eduardo

机构信息

Sociedad Argentina de Farmacología Clínica, Asociación Médica Argentina, Buenos Aires, Argentina.

Hospital de Clínicas 'José de San Martín', Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina.

出版信息

Front Pharmacol. 2021 Mar 29;12:603736. doi: 10.3389/fphar.2021.603736. eCollection 2021.

DOI:10.3389/fphar.2021.603736
PMID:33854432
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8039444/
Abstract

COVID-19 pandemic demands a swift response to find therapeutic tools that effectively reduce morbidity and mortality. Despite initial fears, evidence from retrospective observational studies supports the inhibition of the renin-angiotensin system as an emerging pathway to delay or moderate angiotensin II-driven lung inflammation. This has triggered several prospective clinical trials. In this commentary we provide an overview and analysis of current ongoing clinical trials aimed at evaluating the therapeutic efficacy of angiotensin receptor blocker (ARB) use in COVID-19. The relevance of the results of these trials will have to be interpreted depending on the stage and severity of the disease and in light of the start time of their prescription related to the time of diagnosis of COVID-19 as well as the administered doses.

摘要

新冠疫情需要迅速做出反应，以找到能有效降低发病率和死亡率的治疗手段。尽管最初令人担忧，但回顾性观察研究的证据支持抑制肾素-血管紧张素系统，这是延缓或减轻血管紧张素II驱动的肺部炎症的一条新途径。这引发了多项前瞻性临床试验。在这篇评论中，我们概述并分析了当前正在进行的旨在评估血管紧张素受体阻滞剂（ARB）用于治疗新冠疗效的临床试验。这些试验结果的相关性将必须根据疾病的阶段和严重程度，以及与新冠诊断时间相关的用药开始时间和给药剂量来解读。