Dankers Marloes, Nelissen-Vrancken H Marjorie J M G, Berger Marjolein Y, Bonten Marc J M, van Gerven Joop M A, Kunst Peter W A, Muller Majon, Olde Rikkert Marcel G M, Rosendaal Frits R
Instituut Verantwoord Medicijngebruik, Utrecht.
Contact: Marloes Dankers (
Ned Tijdschr Geneeskd. 2022 Jul 21;166:D6675.
The anti-inflammatory agents dexamethasone (corticosteroid), and tocilizumab and sarilumab (IL6-inhibitors) are effective in the treatment of late COVID-19. Other anti-inflammatory agents, like anakinra (IL1-inhibitor), baricitinib and tofacitinib (JAK-inhibitors) and lenzilumab (GM-CSF-inhibitor) have also shown positive results in late COVID-19. For the treatment of early COVID-19, the inhalation corticosteroid budesonide is regarded as an off-label treatment option. Virus-inhibitors, like remdesivir, molnupiravir and nirmatrelvir/ritonavir decrease the risk of hospitalization and the development of severe COVID-19 by patients with early symptoms. Monoclonal antibodies have shown limited or no efficacy against the omicron-variant of SARS-CoV-2. Fluvoxamine, l-arginine, AT-527 and ensovibep are considered as potential promising new therapies for the treatment of early COVID-19.
抗炎药物地塞米松（皮质类固醇）、托珠单抗和萨瑞鲁单抗（IL6抑制剂）在治疗新冠病毒感染后期有效。其他抗炎药物，如阿那白滞素（IL1抑制剂）、巴瑞替尼和托法替布（JAK抑制剂）以及伦齐单抗（GM-CSF抑制剂）在新冠病毒感染后期也显示出积极效果。对于新冠病毒感染早期的治疗，吸入性皮质类固醇布地奈德被视为一种超说明书用药的治疗选择。病毒抑制剂，如瑞德西韦、莫努匹拉韦和奈玛特韦/利托那韦，可降低早期有症状患者住院风险以及发展为重症新冠病毒感染的风险。单克隆抗体对新冠病毒奥密克戎变异株显示出有限疗效或无效。氟伏沙明、L-精氨酸、AT-527和恩索韦单抗被认为是治疗新冠病毒感染早期有潜力的新疗法。
