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基于法维拉韦的治疗对 COVID-19 患者结局的影响:一项随机对照试验的系统评价和荟萃分析。

Favipiravir-based treatment for outcomes of patients with COVID-19: a systematic review and meta-analysis of randomized controlled trials.

机构信息

School of Pharmaceutical Sciences and Medical Technology, Putian University, Putian, Fujian, China.

Department of Internal Medicine, Kaohsiung Veterans General Hospital, Tainan Branch, Tainan, Taiwan.

出版信息

Expert Rev Clin Pharmacol. 2022 Jun;15(6):759-766. doi: 10.1080/17512433.2022.2078701. Epub 2022 May 30.

Abstract

BACKGROUND

This meta-analysis of randomized controlled trials (RCTs) investigated the clinical efficacy and safety of favipiravir for patients with mild-to-critical COVID-19.

METHODS

PubMed, Web of Science, Ovid Medline, Embase, and Cochrane Central Register of Controlled Trials were searched for RCTs published before 30 October 2021. Only RCTs that compared the clinical efficacy and safety of favipiravir -based antiviral regimens (study group) with other alternative treatments or placebos (control group) in patients with COVID-19 were included.

RESULTS

Overall, the clinical improvement rate was significantly higher in the study group than in the control group at the assessment conducted after 14 days (OR, 1.83; 95% CI, 1.12-2.98). The rate of virological eradication was significantly higher in the study group than in the control group at the assessment conducted after 28 days (OR, 2.09; 95% CI, 1.15-3.78). No significant difference was observed in the rates of invasive mechanical ventilation requirement or ICU admission, mortality, or risk of an adverse event between the study and control groups.

CONCLUSIONS

Except the clinical improvement rate within 14 days and the virological eradication rate within 28 days, favipiravir-based treatment did not provide significantly additional benefit for patients with COVID-19. Therefore, more evidence is necessary.

摘要

背景

本荟萃分析纳入了随机对照试验(RCT),旨在评估法维拉韦治疗轻至危重新冠肺炎患者的临床疗效和安全性。

方法

检索 PubMed、Web of Science、Ovid Medline、Embase 和 Cochrane 对照试验中心注册库,收集截至 2021 年 10 月 30 日发表的关于法维拉韦治疗 COVID-19 的 RCT 研究。仅纳入比较法维拉韦抗病毒方案(试验组)与其他替代治疗或安慰剂(对照组)治疗 COVID-19 患者的临床疗效和安全性的 RCT。

结果

总体而言,试验组治疗 14 天后的临床改善率明显高于对照组(OR 1.83,95%CI 1.12-2.98)。试验组治疗 28 天后的病毒学清除率明显高于对照组(OR 2.09,95%CI 1.15-3.78)。两组间有创机械通气需求或 ICU 入院率、死亡率或不良事件风险无显著差异。

结论

法维拉韦治疗除了在 14 天内提高临床改善率和在 28 天内提高病毒学清除率方面有一定优势外,对 COVID-19 患者并无明显额外获益。因此,还需要更多的证据支持。

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