Chen Zhaoyan, Tian Fangyuan
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.
Heliyon. 2023 Sep 14;9(9):e20153. doi: 10.1016/j.heliyon.2023.e20153. eCollection 2023 Sep.
Azivudine has undergone a few randomized controlled trials (RCTs) as of late. This study aimed to assess the COVID-19 treatment with azvudine's efficacy and safety.
Through January 20, 2023, systematic searches of PubMed, Embase, ClinicalTrials.gov, International Clinical Trials Registry Platform (ICTRP), Cochrane Central Register of Controlled Trials (CENTRAL), and MedRxiv were conducted to find the RCTs. The included studies' bias risk was evaluated using the Cochrane Handbook for Systematic Reviews of Interventions. Meta-analysis was performed using Revman 5.4 (PROSPERO Code: CRD42023395022).
A total of five RCTs with 1142 COVID-19 patients, 575 of whom received azvudine, were included. Additionally, seven RCTs are currently being conducted. In terms of clinical improvement and PT-PCR (reverse transcription polymerase chain reaction) negativity, the azvudine group had a greater patient percentage than the usual treatment or placebo group. It also took less time for the PT-PCR to become negative. In comparison to the placebo or standard treatment groups, the frequency of adverse events was reduced in the azvudine group (risk ratio [RR] = 0.89, 95% confidence interval [CI]: 0.80 to 0.99) and major adverse events (RR = 0.63, 95% CI: 0.22 to 1.79) groups.
Without the burden of side effects, azvudine can hasten the clinical symptoms of COVID-19 patients and PT-PCR negative. It will take more extensive research to confirm these conclusions.
阿兹夫定近期已开展了多项随机对照试验（RCT）。本研究旨在评估阿兹夫定治疗新型冠状病毒肺炎（COVID-19）的疗效和安全性。
截至2023年1月20日，通过系统检索PubMed、Embase、ClinicalTrials.gov、国际临床试验注册平台（ICTRP）、Cochrane系统评价对照试验中心注册库（CENTRAL）和MedRxiv，以查找随机对照试验。使用《Cochrane干预措施系统评价手册》评估纳入研究的偏倚风险。使用Revman 5.4进行荟萃分析（PROSPERO编号：CRD42023395022）。
共纳入5项随机对照试验，涉及1142例COVID-19患者，其中575例接受了阿兹夫定治疗。此外，目前还有7项随机对照试验正在进行。在临床改善和逆转录聚合酶链反应（PT-PCR）转阴方面，阿兹夫定组患者的比例高于常规治疗组或安慰剂组。PT-PCR转阴所需时间也更短。与安慰剂组或标准治疗组相比，阿兹夫定组不良事件的发生率降低（风险比[RR]=0.89，95%置信区间[CI]：0.80至0.99），主要不良事件（RR=0.63，95%CI：0.22至1.79）组也是如此。
在无副作用负担的情况下，阿兹夫定可加速COVID-19患者的临床症状改善及PT-PCR转阴。需要更多广泛的研究来证实这些结论。
