Department of Biosystems, Laboratory of Gene Technology, KU Leuven, Leuven, Belgium.
Environ Microbiol. 2021 Nov;23(11):6364-6376. doi: 10.1111/1462-2920.15769. Epub 2021 Sep 22.
Vaccines and drugs are the cornerstones in the fight against the SARS-CoV-2 pandemic. While vaccines were a success story, the development of antiviral drugs against SARS-CoV-2 turned out to be difficult. For an accelerated use of antivirals in the clinic, most SARS-CoV-2 antivirals represented repurposed drugs. The present article summarizes the outcomes of clinical trials with antiviral drugs in COVID-19 patients. Many antiviral drugs failed to demonstrate beneficial effects or showed mixed results. One reason for the low success rate of clinical trials was shortcomings of antiviral tests in cell culture systems and another reason was the abundance of ill-coordinated and underpowered clinical trials. However, large pragmatic clinical trials particularly of the British RECOVERY trial series demonstrated that even under emergency situation drug trials can be conducted in a timely way such that the therapy of COVID-19 patients can be based on evidence basis instead on expert opinion or even worse on political pressure.
疫苗和药物是抗击 SARS-CoV-2 大流行的基石。虽然疫苗取得了成功，但开发针对 SARS-CoV-2 的抗病毒药物却遇到了困难。为了在临床上加速使用抗病毒药物，大多数 SARS-CoV-2 抗病毒药物都是重新定位的药物。本文总结了 COVID-19 患者中抗病毒药物临床试验的结果。许多抗病毒药物未能显示出有益的效果或显示出混合的结果。临床试验成功率低的一个原因是抗病毒检测在细胞培养系统中的缺陷，另一个原因是协调不佳和力度不足的临床试验过多。然而，大型实用临床试验，特别是英国 RECOVERY 试验系列，表明即使在紧急情况下，也可以及时进行药物试验，从而使 COVID-19 患者的治疗能够基于证据基础，而不是专家意见，甚至更糟的是基于政治压力。
