Latarissa Irma Rahayu, Khairinisa Miski Aghnia, Iftinan Ghina Nadhifah, Meiliana Anna, Sormin Ida Paulina, Barliana Melisa Intan, Lestari Keri
Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, Indonesia.
Medication Therapy Adherence Clinic (MTAC), Universitas Padjadjaran, Sumedang, Indonesia.
Clin Pharmacol. 2025 Jan 16;17:1-11. doi: 10.2147/CPAA.S493750. eCollection 2025.
Various repurposing drugs have been tested for their efficacy on coronavirus disease 2019 (COVID-19), including antimalarial drugs. During the pandemic, Chloroquine (CQ) and Hydroxychloroquine (HCQ) demonstrated good potential against COVID-19, but further studies showed both drugs had side effects that were more dangerous than the efficacy. This made World Health Organization (WHO) ban the usage for COVID-19 patients. In this context, there is a need to explore other antimalarial drugs as potential therapies for COVID-19. This study provides a descriptive synthesis of clinical trials evaluating antimalarial drugs for COVID-19 treatment conducted after the withdrawal of CQ and HCQ. The method was a literature study using the keywords "antimalarial", "COVID-19", "SARS-CoV-2", "clinical trial", and "randomized controlled trial" on the MEDLINE, Scopus, and Cochrane databases. Inclusion criteria were published clinical trials with randomized controlled trials (RCTs) on the efficacy and safety of single antimalarial drugs for COVID-19, published in English and excluding combination therapies. The results showed 3 antimalarial drugs, namely Quinine Sulfate (QS), Atovaquone (AQ), and Artemisinin-Piperaquine (AP), had gone through clinical trial to assess efficacy and safety against COVID-19 patients. Out of the 3 drugs, only AP showed significant results in the primary outcome, which was the time required to reach undetectable levels of SARS-CoV-2. Furthermore, the intervention group took 10.6 days, and the control group took 19.3 days (p=0.001). Based on this review, AP showed significant potential as a therapy in the fight against COVID-19.
多种重新利用的药物已针对2019冠状病毒病（COVID-19）进行了疗效测试，其中包括抗疟药物。在疫情期间，氯喹（CQ）和羟氯喹（HCQ）对COVID-19显示出良好的潜力，但进一步研究表明这两种药物的副作用比疗效更危险。这使得世界卫生组织（WHO）禁止将其用于COVID-19患者。在此背景下，有必要探索其他抗疟药物作为COVID-19的潜在治疗方法。本研究对在CQ和HCQ停用后评估用于COVID-19治疗的抗疟药物的临床试验进行了描述性综合分析。方法是在MEDLINE、Scopus和Cochrane数据库上进行文献研究，使用关键词“抗疟药”“COVID-19”“严重急性呼吸综合征冠状病毒2（SARS-CoV-2）”“临床试验”和“随机对照试验”。纳入标准为以英文发表的关于单一抗疟药物治疗COVID-19的疗效和安全性的随机对照试验（RCT），排除联合疗法。结果显示，3种抗疟药物，即硫酸奎宁（QS）、阿托伐醌（AQ）和青蒿素哌喹（AP），已进行临床试验以评估对COVID-19患者的疗效和安全性。在这3种药物中，只有AP在主要结局方面显示出显著结果，即达到SARS-CoV-2不可检测水平所需的时间。此外，干预组用时10.6天，对照组用时19.3天（p = 0.001）。基于此综述，AP在对抗COVID-19的治疗中显示出显著潜力。
