دورية أكاديمية
Favipiravir for treating COVID-19.
| العنوان: | Favipiravir for treating COVID-19. |
|---|---|
| المؤلفون: | Korula P; Division of Critical Care Medicine, Christian Medical College, Vellore, India., Alexander H; Department of Infectious Diseases, Christian Medical College, Vellore, India., John JS; Department of Infectious Diseases, Christian Medical College, Vellore, India., Kirubakaran R; Department of Infectious Diseases, Christian Medical College, Vellore, India., Singh B; Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK., Tharyan P; Clinical Epidemiology Unit, Prof. BV Moses Centre for Evidence-Informed Healthcare and Health Policy, Christian Medical College, Vellore, India., Rupali P; Department of Infectious Diseases, Christian Medical College, Vellore, India. |
| المصدر: | The Cochrane database of systematic reviews [Cochrane Database Syst Rev] 2024 Feb 05; Vol. 2. Cochrane AN: CD015219. Date of Electronic Publication: 2024 Feb 05. |
| نوع المنشور: | Systematic Review; Journal Article; Review |
| اللغة: | English |
| بيانات الدورية: | Publisher: Wiley Country of Publication: England NLM ID: 100909747 Publication Model: Electronic Cited Medium: Internet ISSN: 1469-493X (Electronic) Linking ISSN: 13616137 NLM ISO Abbreviation: Cochrane Database Syst Rev |
| أسماء مطبوعة: | Publication: 2004- : Chichester, West Sussex, England : Wiley Original Publication: Oxford, U.K. ; Vista, CA : Update Software, |
| مستخلص: | Background: The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to challenge the health workforce and societies worldwide. Favipiravir was suggested by some experts to be effective and safe to use in COVID-19. Although this drug has been evaluated in randomized controlled trials (RCTs), it is still unclear if it has a definite role in the treatment of COVID-19. Objectives: To assess the effects of favipiravir compared to no treatment, supportive treatment, or other experimental antiviral treatment in people with acute COVID-19. Search Methods: We searched the Cochrane COVID-19 Study Register, MEDLINE, Embase, the World Health Organization (WHO) COVID-19 Global literature on coronavirus disease, and three other databases, up to 18 July 2023. Selection Criteria: We searched for RCTs evaluating the efficacy of favipiravir in treating people with COVID-19. Data Collection and Analysis: We used standard Cochrane methodological procedures for data collection and analysis. We used the GRADE approach to assess the certainty of evidence for each outcome. Main Results: We included 25 trials that randomized 5750 adults (most under 60 years of age). The trials were conducted in Bahrain, Brazil, China, India, Iran, Kuwait, Malaysia, Mexico, Russia, Saudi Arabia, Thailand, the UK, and the USA. Most participants were hospitalized with mild to moderate disease (89%). Twenty-two of the 25 trials investigated the role of favipiravir compared to placebo or standard of care, whilst lopinavir/ritonavir was the comparator in two trials, and umifenovir in one trial. Most trials (24 of 25) initiated favipiravir at 1600 mg or 1800 mg twice daily for the first day, followed by 600 mg to 800 mg twice a day. The duration of treatment varied from five to 14 days. We do not know whether favipiravir reduces all-cause mortality at 28 to 30 days, or in-hospital (risk ratio (RR) 0.84, 95% confidence interval (CI) 0.49 to 1.46; 11 trials, 3459 participants; very low-certainty evidence). We do not know if favipiravir reduces the progression to invasive mechanical ventilation (RR 0.86, 95% CI 0.68 to 1.09; 8 trials, 1383 participants; very low-certainty evidence). Favipiravir may make little to no difference in the need for admission to hospital (if ambulatory) (RR 1.04, 95% CI 0.44 to 2.46; 4 trials, 670 participants; low-certainty evidence). We do not know if favipiravir reduces the time to clinical improvement (defined as time to a 2-point reduction in patients' admission status on the WHO's ordinal scale) (hazard ratio (HR) 1.13, 95% CI 0.69 to 1.83; 4 trials, 721 participants; very low-certainty evidence). Favipiravir may make little to no difference to the progression to oxygen therapy (RR 1.20, 95% CI 0.83 to 1.75; 2 trials, 543 participants; low-certainty evidence). Favipiravir may lead to an overall increased incidence of adverse events (RR 1.27, 95% CI 1.05 to 1.54; 18 trials, 4699 participants; low-certainty evidence), but may result in little to no difference inserious adverse eventsattributable to the drug (RR 1.04, 95% CI 0.76 to 1.42; 12 trials, 3317 participants; low-certainty evidence). Authors' Conclusions: The low- to very low-certainty evidence means that we do not know whether favipiravir is efficacious in people with COVID-19 illness, irrespective of severity or admission status. Treatment with favipiravir may result in an overall increase in the incidence of adverse events but may not result in serious adverse events. (Copyright © 2024 The Authors. Cochrane Database of Systematic Reviews published by John Wiley & Sons, Ltd. on behalf of The Cochrane Collaboration.) |
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| سلسلة جزيئية: | ClinicalTrials.gov https://www.clinicaltrials.gov/ct2/show/NCT04600999; https://ensaiosclinicos.gov.br/rg/RBR-85vh8fx |
| تواريخ الأحداث: | Date Created: 20240205 Latest Revision: 20240722 |
| رمز التحديث: | 20240722 |
| مُعرف محوري في PubMed: | PMC10840071 |
| DOI: | 10.1002/14651858.CD015219.pub2 |
| PMID: | 38314855 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1469-493X |
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| DOI: | 10.1002/14651858.CD015219.pub2 |