Etiotropic therapy of the new coronavirus infection: expectations and realities at the beginning of 2022. Part 1
Olga Yu. Kuznetsova
Russian Family Doctor ›› 2022, Vol. 26 ›› Issue (1) : 7 -14.
Etiotropic therapy of the new coronavirus infection: expectations and realities at the beginning of 2022. Part 1
The review includes an analysis of the latest literature data on the etiotropic therapy of a new coronavirus infection. The search for an effective antiviral treatment for SARS-CoV-2 infection is ongoing. Often, the urgent need for an antiviral drug was a pretext for testing drugs without pharmacological justification, bypassing the generally accepted procedure for conducting multi-stage clinical trials. In this regard, many clinical trials involving thousands of patients did not demonstrate the high efficacy and safety of drugs that were chosen as etiotropic therapy. In this review, we focused on the efficacy and safety of those drugs that have been studied in sufficient detail, which are reflected in international publications, and are also included in Russian guidelines for use on an outpatient practice: favipiravir and molnupiravir. The mechanism of action of antiviral drugs, their effectiveness and possible side effects were studied in clinical trials, the results of which are in the open press, which made it possible to analyze these drugs in terms of the appropriateness of their use in real clinical practice.
new coronavirus infection / outpatient practice / etiotropic treatment / favipiravir / molnupiravir / treatment efficacy / side effects
| [1] |
Wu R, Wang L, Kuo HD, et al. An update on current therapeutic drugs treating COVID-19. Curr Pharmacol Rep. 2020:6(3):56–70. DOI: 10.1007/s40495-020-00216-7 |
| [2] |
Wu R., Wang L., Kuo H.D. et al. An update on current therapeutic drugs treating COVID-19 // Curr. Pharmacol. Rep. 2020. Vol. 6, No. 3. P. 56–70. DOI: 10.1007/s40495-020-00216-7 |
| [3] |
Green N, Ott RD, Isaacs RJ, Fang H. Cell-based assays to identify inhibitors of viral disease. Expert Opin Drug Discov. 2008;3(6):671–676. DOI: 10.1517/17460441.3.6.671 |
| [4] |
Green N., Ott R.D., Isaacs R.J., Fang H. Cell-based assays to identify inhibitors of viral disease // Expert Opin. Drug Discov. 2008. Vol. 3, No. 6. P. 671–676. DOI: 10.1517/17460441.3.6.671 |
| [5] |
Agostini ML, Andres EL, Sims AC, еt al. Coronavirus susceptibility to the antiviral remdesivir (GS-5734) Is mediated by the viral polymerase and the proofreading exoribonuclease. mBio. 2018;9(2):e00221–18. DOI: 10.1128/mBio.00221-18 |
| [6] |
Agostini M.L., Andres E.L., Sims A.C. еt al. Coronavirus susceptibility to the antiviral remdesivir (GS-5734). Is mediated by the viral polymerase and the proofreading exoribonuclease // mBio. 2018. Vol. 9, No. 2. P. e00221–18. DOI: 10.1128/mBio.00221-18 |
| [7] |
Vremennye metodicheskie rekomendatsii. Diagnostika, profilaktika i lechenie novoy koronavirusnoy infektsii (COVID-19). Versiya 7 (03.06.2020) [Internet]. Available from: http://edu.rosminzdrav.ru/fileadmin/user_upload/specialists/COVID-19/MR_COVID-19_v7.pdf. Accessed: March 3, 2022. (In Russ.) |
| [8] |
Временные методические рекомендации. Диагностика, профилактика и лечение новой коронавирусной инфекции (COVID-19). Версия 7 (03.06.2020) [Электронный ресурс]. Режим доступа: http://edu.rosminzdrav.ru/fileadmin/user_upload/specialists/COVID-19/MR_COVID-19_v7.pdf. Дата обращения: 03.03.2022. |
| [9] |
Kandimalla R, John A, Abburi C, et al. Current status of multiple drug molecules, and vaccines: an update in SARS-CoV-2 Therapeutics. Mol Neurobiol. 2020;57(10):4106–4116. DOI: 10.1007/s12035-020-02022-0 |
| [10] |
Kandimalla R., John A., Abburi C. et al. Current status of multiple drug molecules, and vaccines: an update in SARS-CoV-2 therapeutics // Mol. Neurobiol. 2020. Vol. 57, No. 10. P. 4106–4116. DOI: 10.1007/s12035-020-02022-0 |
| [11] |
VOZ prekrashchaet izyskaniya v gruppakh lecheniya COVID-19 gidroksikhlorokhinom i kombinatsiey lopinavira i ritonavira [Internet]. Available from: https://www.who.int/ru/news/item/04-07-2020-who-discontinues-hydroxychloroquine-and-lopinavir-ritonavir-treatment-arms-for-covid-19. Accessed: March 3, 2022. (In Russ.) |
| [12] |
ВОЗ прекращает изыскания в группах лечения COVID-19 гидроксихлорохином и комбинацией лопинавира и ритонавира [Электронный ресурс]. Режим доступа: https://www.who.int/ru/news/item/04-07-2020-who-discontinues-hydroxychloroquine-and-lopinavir-ritonavir-treatment-arms-for-covid-19. Дата обращения: 03.03.2022. |
| [13] |
Vremennye metodicheskie rekomendatsii. Diagnostika, profilaktika i lechenie novoi koronavirusnoy infektsii (COVID-19). Versiya 10 (08.02.2021) [Internet]. Available from: https://static-0.minzdrav.gov.ru/system/attachments/attaches/000/054/662/original/COVID-19_%28v.10%29.pdf. Accessed: March 3, 2022. (In Russ.) |
| [14] |
Временные методические рекомендации. Диагностика, профилактика и лечение новой коронавирусной инфекции (COVID-19). Версия 10 (08.02.2021) [Электронный ресурс]. Режим доступа: https://static-0.minzdrav.gov.ru/system/attachments/attaches/000/054/662/original/COVID-19_%28v.10%29.pdf. Дата обращения: 03.03.2022. |
| [15] |
WHO recommends against the use of remdesivir in COVID-19 patients [Internet]. Available from: https://www.who.int/news-room/feature-stories/detail/who-recommends-against-the-use-of-remdesivir-in-covid-19-patients#. Accessed: March 3, 2022. |
| [16] |
WHO recommends against the use of remdesivir in COVID-19 patients [Электронный ресурс]. Режим доступа: https://www.who.int/news-room/feature-stories/detail/who-recommends-against-the-use-of-remdesivir-in-covid-19-patients#. Дата обращения: 03.03.2022. |
| [17] |
Agarwal A, Rochwerg B, Lamontagne F, et al. A living WHO guideline on drugs for COVID-19. BMJ. 2020;370:m3379. DOI: 10.1136/bmj.m3379 |
| [18] |
Agarwal A., Rochwerg B., Lamontagne F. et al. A living WHO guideline on drugs for COVID-19 // BMJ. 2020;370:m3379. DOI: 10.1136/bmj.m3379 |
| [19] |
Vremennye metodicheskie rekomendatsii. Diagnostika, profilaktika i lechenie novoy koronavirusnoy infektsii (COVID-19). Versiya 14 (27.12.2021). [Internet]. Available from: https://xn--80aesfpebagmfblc0a.xn--p1ai/ai/doc/1213/attach/vmr_COVID-19_V14_27-12-2021.pdf. Accessed: March 3, 2022. (In Russ.) |
| [20] |
Временные методические рекомендации. Диагностика, профилактика и лечение новой коронавирусной инфекции (COVID-19). Версия 14 (27.12.2021). [Электронный ресурс]. Режим доступа: https://xn--80aesfpebagmfblc0a.xn--p1ai/ai/doc/1213/attach/vmr_COVID-19_V14_27-12-2021.pdf. Дата обращения: 03.03.2022. |
| [21] |
Jalali N, Brustad HK, Frigessi A, et al. Increased household transmission and immune escape of the SARS-CoV-2 Omicron variant compared to the Delta variant: evidence from Norwegian contact tracing and vaccination data. medRxiv. DOI: 10.1101/2022.02.07.22270437 |
| [22] |
Jalali N., Brustad H.K., Frigessi A. et al. Increased household transmission and immune escape of the SARS-CoV-2 Omicron variant compared to the Delta variant: evidence from Norwegian contact tracing and vaccination data // medRxiv. DOI: 10.1101/2022.02.07.22270437 |
| [23] |
Kaur RJ, Charan J, Dutta S, et al. Favipiravir use in COVID-19: Analysis of suspected adverse drug events reported in the WHO database. Infect Drug Resist. 2020;13:4427–4438. DOI: 10.2147/IDR.S287934 |
| [24] |
Kaur R.J., Charan J., Dutta S. et al. Favipiravir use in COVID-19: Analysis of suspected adverse drug events reported in the WHO database // Infect. Drug Resist. 2020. Vol. 13. P. 4427–4438. DOI: 10.2147/IDR.S287934 |
| [25] |
Eloy P, Le Grand R, Malvy D, Guedj J. Combined treatment of molnupiravir and favipiravir against SARS-CoV-2 infection: One + zero equals two? EBioMedicine. 2021;74:103663. DOI: 10.1016/j.ebiom.2021.103595 |
| [26] |
Eloy P., Le Grand R., Malvy D., Guedj J. Combined treatment of molnupiravir and favipiravir against SARS-CoV-2 infection: One + zero equals two? // EBioMedicine. 2021;74:103663. DOI: 10.1016/j.ebiom.2021.103595 |
| [27] |
Tejaswi P, Devashish K, Prasad RR. Pharmacological effects of Favipiravir on coronavirus: An update. Biomed Pharmacol J. 2021;14(2):1087–1095. DOI: 10.13005/bpj/2212 |
| [28] |
Tejaswi P., Devashish K., Prasad R.R. Pharmacological effects of Favipiravir on coronavirus: an update // Biomed. Pharmacol. J. 2021;14(2):1087–1095. DOI: 10.13005/bpj/2212 |
| [29] |
Kiselev YuYu, Matveev AV, Mirzaev KB, Sychev DA. Monitoring of safety using favipiravir: risk management of adverse drug reactions in clinical practice. Good Clinical Practice. 2020;(4S):115–119. (In Russ.). DOI: 10.37489/2588-0519-2020-S4-115-119 |
| [30] |
Киселёв Ю.Ю., Матвеев А.В., Мирзаев К.Б., Сычёв Д.А. Мониторинг безопасности применения фавипиравира: управление рисками развития нежелательных лекарственных реакций в клинической практике // Качественная клиническая практика. 2020. № S4. С.115–119. DOI: 10.37489/2588-0519-2020-S4-115-119 |
| [31] |
Ruzhentsova TA, Chukhlyaev PV, Khavkina DA, et al. Efficacy and safety of favipiravir in a complex therapy of mild to moderate COVID-19. Infectious Diseases: News, Opinions, Training. 2020;9(4):26–38. (In Russ.). DOI: 10.33029/2305- 3496-2020-9-4-26-38 |
| [32] |
Руженцова Т.А., Чухляев П.В., Хавкина Д.А. и др. Эффективность и безопасность применения фавипиравира в комплексной терапии COVID-19 легкого и среднетяжелого течения // Инфекционные болезни: новости, мнения, обучение. 2020. Т. 9, № 4. С. 26–38. DOI: 10.33029/2305- 3496-2020-9-4-26-38 |
| [33] |
Özlüşen B, Kozan Ş, Akcan RE, et al. Effectiveness of favipiravir in COVID-19: a live systematic review. Eur J Clin Microbiol Infect Dis. 2021;40(12):2575–2583. DOI: 10.1007/s10096-021-04307-1 |
| [34] |
Özlüşen B., Kozan Ş., Akcan R.E. et al. Effectiveness of favipiravir in COVID-19: a live systematic review // Eur. J. Clin. Microbiol. Infect. Dis. 2021. Vol. 40, No. 12. P. 2575–2583. DOI: 10.1007/s10096-021-04307-1 |
| [35] |
Painter WP, Holman WL, Bush JA, et al. Human safety, tolerability, and pharmacokinetics of molnupiravir, a novel broad-spectrum oral antiviral agent with activity against SARS-CoV-2. Antimicrob Agents Chemother. 2021;65(5):e02428–20. DOI: 10.1128/AAC.02428-20 |
| [36] |
Painter W.P., Holman W.L., Bush J.A. et al. Human safety, tolerability, and pharmacokinetics of molnupiravir, a novel broad-spectrum oral antiviral agent with activity against SARS-CoV-2 // Antimicrob. Agents Chemother. 2021. Vol. 65, No. 5. P. e02428–20. DOI: 10.1128/AAC.02428-20 |
| [37] |
Arribas JR, Bhagani S, Lobo SM, et al. randomized trial of molnupiravir or placebo in patients hospitalized with COVID-19. NEJM Evid. 2021;1(2). DOI: 10.1056/EVIDoa2100044 |
| [38] |
Arribas J.R., Bhagani S., Lobo S.M. et al. randomized trial of molnupiravir or placebo in patients hospitalized with Covid-19 // NEJM Evid. 2021. Vol. 1, No. 2. DOI: 10.1056/EVIDoa2100044 |
| [39] |
Caraco Y, Crofoot GE, Moncada PA, et al. Phase 2/3 Trial of molnupiravir for treatment of Covid-19 in nonhospitalized adults. NEJM Evid. 2021;1(2). DOI: 10.1056/EVIDoa2100043 |
| [40] |
Caraco Y., Crofoot G.E., Moncada P.A. et al. Phase 2/3 trial of molnupiravir for treatment of Covid-19 in nonhospitalized adults // NEJM Evid. 2021. Vol. 1, No. 2. DOI: 10.1056/EVIDoa2100043 |
| [41] |
Jayk Bernal A, Gomes da Silva MM, Musungaie DB, et al. Molnupiravir for oral treatment of COVID-19 in nonhospitalized patients. N Engl J Med. 2022;386(6):509–520. DOI: 10.1056/NEJMoa2116044 |
| [42] |
Jayk Bernal A., Gomes da Silva M.M., Musungaie D.B. et al. Molnupiravir for oral treatment of COVID-19 in nonhospitalized patients // N. Engl. J. Med. 2022. Vol. 386, No. 6. P. 509–520. DOI: 10.1056/NEJMoa2116044 |
| [43] |
Castillo Almeida NE, Kalil AC. Molnupiravir: Is it time to move in or move out? NEJM Evid. 2021;1(2). DOI: 10.1056/EVIDe2100048 |
| [44] |
Castillo Almeida N.E., Kalil A.C. Molnupiravir: Is it time to move in or move out? // NEJM Evid. 2021. Vol. 1, No. 2. DOI: 10.1056/EVIDe2100048 |
| [45] |
Vremennye metodicheskie rekomendatsii. Diagnostika, profilaktika i lechenie novoy koronavirusnoy infektsii (COVID-19). Versiya 15 (22.02.2022) [Internet]. Available from: https://static-0.minzdrav.gov.ru/system/attachments/attaches/000/059/392/original/COVID-19_V15.pdf. Accessed: March 3, 2022. (In Russ.) |
| [46] |
Временные методические рекомендации. Диагностика, профилактика и лечение новой коронавирусной инфекции (COVID-19). Версия 15 (22.02.2022) [Электронный ресурс]. Режим доступа: https://static-0.minzdrav.gov.ru/system/attachments/attaches/000/059/392/original/COVID-19_V15.pdf. Дата обращения: 03.03.2022. |
Kuznetsova O.Y.
/
| 〈 |
|
〉 |