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甲磺酸卡莫司他治疗 COVID-19 的安全性和有效性：一项随机对照试验的系统评价和 Meta 分析。

Safety and Efficacy of Camostat Mesylate for Covid-19: a systematic review and Meta-analysis of Randomized controlled trials.

机构信息

King Edward Medical University, Lahore, Pakistan.

Akhtar Saeed Medical and Dental College, Lahore, Pakistan.

出版信息

BMC Infect Dis. 2024 Jul 19;24(1):709. doi: 10.1186/s12879-024-09468-w.

DOI:10.1186/s12879-024-09468-w
PMID:39030491
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11264738/
Abstract

BACKGROUND

Camostat mesylate, an oral serine protease inhibitor, is a powerful TMPRSS2 inhibitor and has been reported as a possible antiviral treatment against COVID-19. Therefore, we aim to assess the safety and efficacy of camostat mesylate for COVID-19 treatment.

METHODS

A systematic review and meta-analysis synthesizing randomized controlled trials from PubMed, Scopus, Embase, Cochrane, Web of Science, clinical trials.gov, and medrxiv until June 2023. The outcomes were pooled using Mean difference (MD) for continuous outcomes and risk ratio (RR) for dichotomous outcomes. The protocol is registered in PROSPERO with ID CRD42023439633.

RESULTS

Nine RCTs, including 1,623 patients, were included in this analysis. There was no difference between camostat mesylate and placebo in producing negative PCR test results at 1-7 days (RR: 0.76, 95% CI: [0.54, 1.06] P = 0.1), 8-14 days (RR: 1.02, 95% CI: [0.84, 1.23] P = 0.87), or 15-21 days (RR: 0.99, 95% CI: [0.82, 1.19] P = 0.90); clinical resolution of symptoms at 1-7 days (RR: 0.94 (95% CI: 0.58, 1.53) P = 0.81), 8-14 days (RR: 0.91, 95% CI: [0.74, 1.11] P = 0.33, ), or 15-21 days (RR: 0.77, 95% CI: [0.40, 1.51] P = 0.45); and time to symptom improvement (MD:-0.38 weeks (95% CI: [-1.42, 0.66] P = 0.47, I = 85%).

CONCLUSION

Camostat mesylate did not improve clinical outcomes in patients with COVID-19, compared to placebo.

摘要

背景

甲磺酸卡莫司他是一种口服丝氨酸蛋白酶抑制剂，是一种强效的 TMPRSS2 抑制剂，有报道称其可能是 COVID-19 的一种抗病毒治疗药物。因此，我们旨在评估甲磺酸卡莫司他治疗 COVID-19 的安全性和疗效。

方法

系统检索 PubMed、Scopus、Embase、Cochrane、Web of Science、clinicaltrials.gov 和 medrxiv 数据库，截至 2023 年 6 月，对所有随机对照试验进行综合分析。采用均数差（MD）比较连续变量，风险比（RR）比较二分类变量。该方案在 PROSPERO 注册，注册号为 CRD42023439633。

结果

共纳入 9 项 RCT 研究，包括 1623 例患者。与安慰剂相比，甲磺酸卡莫司他在第 1-7 天（RR：0.76，95%CI：[0.54，1.06]，P=0.1）、第 8-14 天（RR：1.02，95%CI：[0.84，1.23]，P=0.87）或第 15-21 天（RR：0.99，95%CI：[0.82，1.19]，P=0.90）产生阴性 PCR 检测结果方面无差异；在第 1-7 天（RR：0.94，95%CI：[0.58，1.53]，P=0.81）、第 8-14 天（RR：0.91，95%CI：[0.74，1.11]，P=0.33）或第 15-21 天（RR：0.77，95%CI：[0.40，1.51]，P=0.45）症状缓解时间无差异；临床症状改善时间（MD：-0.38 周（95%CI：[-1.42，0.66]，P=0.47，I²=85%））无差异。

结论

与安慰剂相比，甲磺酸卡莫司他并未改善 COVID-19 患者的临床结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9357/11264738/3428fe8ced9b/12879_2024_9468_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9357/11264738/49a16d9fdcdb/12879_2024_9468_Fig1_HTML.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9357/11264738/b9f603f42170/12879_2024_9468_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9357/11264738/3428fe8ced9b/12879_2024_9468_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9357/11264738/49a16d9fdcdb/12879_2024_9468_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9357/11264738/185fd6a6319b/12879_2024_9468_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9357/11264738/7b96d876f5de/12879_2024_9468_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9357/11264738/b9f603f42170/12879_2024_9468_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9357/11264738/3428fe8ced9b/12879_2024_9468_Fig5_HTML.jpg

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