Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, China.
Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
J Med Virol. 2023 Apr;95(4):e28732. doi: 10.1002/jmv.28732.
At present, there are some differences in the research results of nirmatrelvir-ritonavir compared with other antiviral drugs for the treatment of COVID-19 patients. We aimed to evaluate the efficacy and safety of nirmatrelvir-ritonavir compared with other antiviral drugs and the impact of different antiviral drugs on the short- and long-term effects of COVID-19. PubMed, Embase, CENTRAL (Cochrane Central Register of Controlled Trials), Web of Science, Google Scholar, and MedRxiv were searched to identify relevant studies from inception to March 30, 2023. We conducted a meta-analysis to estimate the effects of nirmatrelvir-ritonavir compared with other antiviral drugs for the treatment of COVID-19 patients and safety outcomes. The RoB1 and ROBINS-I were used to assess the bias risk of the included studies. Revman 5.4 software was used for meta-analysis (PROSPERO Code No: CRD42023397816). Twelve studies were included, including 30 588 COVID-19 patients, of whom 13 402 received nirmatrelvir-ritonavir. The meta-analysis results showed that the nirmatrelvir-ritonavir group had a lower proportion of patients than the control group in terms of long-term mortality (odds ratio [OR] = 0.29, 95% confidence interval [CI]: 0.13-0.66), hospitalization (OR = 0.44, 95% CI: 0.37-0.53, short term; OR = 0.52, 95% CI: 0.36-0.77, long term), and disease progression (OR = 0.56, 95% CI: 0.38-0.83, short term; OR = 0.60, 95% CI: 0.48-0.74, long term), and nirmatrelvir ritonavir showed little difference in safety compared to the control group. Nirmatrelvir-ritonavir can reduce the mortality and hospitalization of COVID-19 patients compared with other antiviral drugs. Further large-scale studies remain to validate these findings.
目前，奈玛特韦-利托那韦与其他抗新冠病毒药物治疗 COVID-19 患者的研究结果存在一些差异。我们旨在评估奈玛特韦-利托那韦与其他抗病毒药物相比的疗效和安全性，以及不同抗病毒药物对 COVID-19 短期和长期效果的影响。我们检索了 PubMed、Embase、CENTRAL（Cochrane 对照试验中心注册库）、Web of Science、Google Scholar 和 MedRxiv，以确定截至 2023 年 3 月 30 日的相关研究。我们进行了荟萃分析，以评估奈玛特韦-利托那韦与其他抗病毒药物治疗 COVID-19 患者的疗效和安全性结局。我们使用 RoB1 和 ROBINS-I 来评估纳入研究的偏倚风险。Revman 5.4 软件用于荟萃分析（PROSPERO 编号：CRD42023397816）。共纳入 12 项研究，包括 30588 例 COVID-19 患者，其中 13402 例接受了奈玛特韦-利托那韦治疗。荟萃分析结果显示，与对照组相比，奈玛特韦-利托那韦组的长期死亡率（比值比[OR] = 0.29，95%置信区间[CI]：0.13-0.66）、住院率（OR = 0.44，95%CI：0.37-0.53，短期；OR = 0.52，95%CI：0.36-0.77，长期）和疾病进展率（OR = 0.56，95%CI：0.38-0.83，短期；OR = 0.60，95%CI：0.48-0.74，长期）均较低，且与对照组相比，奈玛特韦-利托那韦在安全性方面差异不大。奈玛特韦-利托那韦可降低 COVID-19 患者的死亡率和住院率，优于其他抗病毒药物。需要进一步的大规模研究来验证这些发现。
