Frontiers in Cellular and Infection Microbiology, Год журнала: 2024, Номер 14
Опубликована: Ноя. 22, 2024
Azvudine (AZV), the first Chinese oral anti-coronavirus disease 2019 (COVID-19) drug, has shown substantial clinical benefits to viral clearance and prognosis in patients with mild common COVID-19. However, there is no evidence severe hospitalized COVID-19 patients.
Язык: Английский
EClinicalMedicine, Год журнала: 2024, Номер 69, С. 102468 - 102468
Опубликована: Фев. 9, 2024
BackgroundAzvudine and nirmatrelvir/ritonavir are approved to treat mild-to-moderate coronavirus disease 2019 (COVID-19) in adults with a high risk for progression severe infection. We sought compare the antiviral effectiveness clinical outcomes of elderly patients COVID-19 receiving these two agents.MethodsIn this observational study, we identified 249 infection who were admitted Second Medical Center People's Liberation Army General Hospital from December 2022 January 2023, including 128 azvudine recipients, 66 recipients 55 not received treatments. compared cycle threshold (Ct) value dynamic change all three groups. The primary outcome was composite progression, all-cause death, intensive care unit admission, initiation invasive mechanical ventilation. enrolled followed up electronic medical record system. Kaplan–Meier Cox proportional regression analyses used To more directly drugs, performed propensity-score matching between groups efficacy matched population.FindingsAmong (mean age, 91.41 years), 77 died during follow-up period. When did receive any antivirals, neither nor demonstrated survival benefit. analysis death showed that 0.730 (0.423–1.262) group 0.802 (0.435–1.480) non-antiviral group. After propensity score matching, included 58 recipients. fitted curve Ct after illustrated rate viral decline early stage treatment seems surpass azvudine, but there no statistical significance. Azvudine seemly associated lower (HR:1.676, 95% CI:0.805–3.488) short-term (HR: 1.291, 95%CI: 0.546–3.051).InterpretationPatients have similar trend nirmatrelvir/ritonavir. In limited series, significant This lack benefit might be attributed potential bias.FundingThis study supported by "National Key R&D Program China" (Funding No. 2020YFC2008900) National Defense Science Technology Innovation Special Zone Project (223-CXCY-N101-07-18-01).
Язык: Английский
Процитировано
11
Acta Pharmaceutica Sinica B, Год журнала: 2025, Номер 15(3), С. 1333 - 1343
Опубликована: Янв. 1, 2025
Azvudine and nirmatrelvir/ritonavir (Paxlovid) are recommended for COVID-19 treatment in China, but their safety efficacy the elderly population not fully known. In this multicenter, retrospective, cohort study, we identified 5131 hospitalized patients from 32,864 admitted to nine hospitals Henan Province, December 5, 2022, January 31, 2023. The primary outcome was all-cause death, secondary composite disease progression. Propensity score matching (PSM) performed control confounding factors, including demographics, vaccination status, comorbidities, laboratory tests. After 2:1 PSM, 1786 receiving azvudine 893 Paxlovid were included. Kaplan-Meier Cox regression analyses revealed that compared with group, could significantly reduce risk of death (log-rank P = 0.002; HR: 0.71, 95% CI: 0.573-0.883, 0.002), there no difference progression 0.52; 1.05, 0.877-1.260, 0.588). Four sensitivity verified robustness above results. Subgroup analysis suggested a greater benefit over observed malignant tumors (P interaction 0.005, 0.32, 0.18-0.57) without tumors. Safety had lower incidence adverse events higher lymphocyte levels than treatment. conclusion, is inferior terms patients.
Язык: Английский
Процитировано
1
Reviews in Medical Virology, Год журнала: 2024, Номер 34(4)
Опубликована: Июнь 7, 2024
Abstract This systematic review and meta‐analysis aimed to compare the effectiveness safety of azvudine versus nirmatrelvir/ritonavir (Paxlovid) in treating coronavirus disease 2019 (COVID‐19). The researchers conducted searches on PubMed, Cochrane Library, Web Science, medRxiv, Google Scholar until January 2024. risk bias tool was utilised evaluate quality included studies, data analysis performed using Comprehensive Meta‐Analysis software. Thirteen including 4949 patients, were analysed. results showed no significant difference between Paxlovid groups terms mortality rate (odds [OR] = 0.84, 95% confidence interval [CI]: 0.59–1.21), negative polymerase chain reaction (PCR) conversion time (standard mean [SMD] 1.52, CI: −1.07–4.11), hospital stay (SMD −0.39, −1.12–0.33). However, a observed two intensive care unit admission (OR 0.42, 0.23–0.75) need for mechanical ventilation 0.61, 0.44–0.86) favour azvudine. incidence adverse events group significantly lower 0.66, 0.43–0.99). certainty evidence rated as low moderate. Azvudine demonstrated similar reducing rates, PCR stay. better improving other outcomes. Regarding level evidence, further research is needed validate or challenge these results.
Язык: Английский
Процитировано
6
Frontiers in Pharmacology, Год журнала: 2025, Номер 16
Опубликована: Апрель 4, 2025
Objective To explore the effectiveness and safety of azvudine nirmatrelvir-ritonavir in a real-world setting. Methods This retrospective cohort study included adult patients with confirmed COVID-19 who received or treatment at Shanghai Changhai Hospital between 1 November 2022, 30 March 2023. Data were collected from hospital’s electronic medical record system using standardized data extraction form. Propensity score matching (PSM) was used to control for potential confounding factors. The primary outcome incidence composite disease progression, defined as occurrence death, ICU admission, invasive respiratory support, high-flow oxygen therapy. Multivariable Cox regression analysis performed identify factors independently associated progression outcomes. Results 476 patients: 296 treated 180 nirmatrelvir-ritonavir. After PSM, 139 each group. There no statistically significant differences two groups regarding (log-rank: P = 0.475; HR: 0.82, 95%CI: 0.46–1.43, 0.478), death 0.526; 0.44–1.52, 0.528), admission 0.525; 0.69, 0.22–2.18, 0.526), ventilation 0.814; 1.20, 0.27–5.39, 0.814), use 0.370; 1.44, 0.65–3.18, 0.372). multivariable showed that antiviral drug (HR 0.861, 0.486–1.524, 0.607) not outcome. Only severe 3.322, 1.569–7.031, 0.002). outcomes similar groups. Conclusion demonstrates comparable efficacy profiles treating patients, regardless severity baseline characteristics. findings support practical alternative selection, particularly resource-constrained settings contraindications specific therapies. Clinical decisions should prioritize patient-specific needs, accessibility, cost-effectiveness. Further large-scale prospective studies are needed validate these observations refine subgroup-specific strategies.
Язык: Английский
Процитировано
0
Frontiers in Pharmacology, Год журнала: 2025, Номер 16
Опубликована: Апрель 25, 2025
The global impact of COVID-19 has highlighted the urgent need for effective therapeutic interventions against SARS-CoV-2. Azvudine, a dual-target nucleoside drug initially developed human immunodeficiency virus (HIV), gained attention its potential in treating COVID-19. On 25 July 2022, Azvudine received conditional approval from National Medical Products Administration (NMPA) China, making it first oral SARS-CoV-2 RNA-dependent RNA polymerase (RdRp) inhibitor treatment. This review explores pharmacological activity, antiviral mechanisms, and clinical effectiveness azvudine context Clinical trials have demonstrated ability to reduce viral load, shorten time nucleic acid negativity, improve outcomes patients. Additionally, shown excellent pharmacokinetic properties favorable safety profile with mild side effects. also addresses importance interactions considerations, particularly high-risk populations. Research should focus on optimizing second-generation inhibitors enhanced variants, improving bioavailability, minimizing adverse effects, ensuring more robust treatment options
Язык: Английский
Процитировано
0
PLoS ONE, Год журнала: 2024, Номер 19(6), С. e0298772 - e0298772
Опубликована: Июнь 13, 2024
Objective The aim of this study was to assess the effectiveness and safety azvudine in treating coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome 2 (SARS-COV-2). Methods A search carried out PubMed, Cochrane Library, Web Science, medRxiv, Google Scholar until October 20, 2023. risk bias tools were used quality included studies. Comprehensive Meta-Analysis software analyze data. Results Twenty-one studies including 10,011 patients examined. meta-analysis results showed that standard care/placebo (SOC/PBO) significantly different concerning mortality rate (risk ratio [RR] = 0.48, 95% confidence interval [CI]: 0.40 0.57) negative polymerase chain reaction (PCR) conversion time (standard mean difference - 0.75, CI: -1.29 to—0.21). However, two groups did not show significant differences hospital stay, intensive care unit (ICU) admission, need for mechanical ventilation (P > 0.05). On other hand, nirmatrelvir-ritonavir (RR 0.73, 0.58 0.92), ICU admission 0.41, 0.21 0.78), 0.67, 0.51 0.89), but treatments PCR time, stay incidence adverse events between certainty evidence rated as low or moderate. Conclusions antiviral against SARS-COV-2 is questionable with regard evidence. Further research should be conducted establish COVID-19.
Язык: Английский
Процитировано
2
Frontiers in Pharmacology, Год журнала: 2024, Номер 15
Опубликована: Июль 22, 2024
Introduction: Numerous studies have explored the treatment outcomes of Nirmatrelvir-Ritonavir and Azvudine in older patients with COVID-19. However, direct comparisons between these two drugs are still relatively limited. This study aims to compare safety effectiveness Chinese early infection provide strategies for clinical treatment. Methods: Older COVID-19 (age ≥65) hospitalized during winter 2022 epidemic China were included divided into Azvudine. Demographics, medication information, laboratory parameters, collected. All-cause 28-day mortality, delta cycle threshold (ΔCt), nucleic acid negative conversion time, incidence adverse events defined as outcomes. Propensity score matching (PSM), Kaplan-Meier, Cox proportional hazards model, subgroup analysis, nomograms selected evaluate Results: A total 1,508 screened. Based on inclusion exclusion criteria, 1,075 eligible study. After PSM, final number was 375, there no significant differences demographic characteristics groups ( p > 0.05). Compared group, group showed a higher multiple (12.8% vs 5.2%, = 0.009). The related abnormal renal function compared (13.6% 7.2%, 0.045). There terms all-cause mortality (HR 1.020, 95% CI: 0.542 - 1.921, 0.951), whereas time 1.659, 1.166 2.360, 0.005) ΔCt values 1.442, 1.084 1.918, 0.012). Conclusion: comparable reducing risk. may perform better virus clearance shows slightly patients. Further larger sample size needed validate result.
Язык: Английский
Процитировано
2
Infection and Drug Resistance, Год журнала: 2023, Номер Volume 16, С. 7797 - 7808
Опубликована: Дек. 1, 2023
Purpose: To compare the effectiveness of azvudine and nirmatrelvir/ritonavir for treatment coronavirus disease (COVID-19). Patients Methods: We conducted a retrospective analysis data from 576 patients with COVID-19, comprising 195 without antiviral therapy, 226 treated azvudine, 114 nirmatrelvir/ritonavir, 41 were concurrently. compared their symptoms, mortality rates, length cost hospitalization. Results: The incidence symptoms was similar in those nirmatrelvir/ritonavir. However, among experiencing weakness, duration weakness significantly shorter group than (P=0.029). Mortality did not differ between (18.14% vs.10.53%, P=0.068). Among "severe patients", rate markedly lower (16.92% vs.32.17%, P=0.026). In hepatic insufficiency, had substantially (15.09% vs.34.25%, P=0.016). addition, longer hospital stays (P=0.002) higher costs (P< 0.001) receiving azvudine. Compared or alone, taking concurrently no significant improvement survival (P> 0.05), stay 0.05). Conclusion: Azvudine is recommended non-severe COVID-19 weakness. Nirmatrelvir/ritonavir severe to reduce mortality, it could be best choice insufficiency. concurrent use recommended. Keywords: SARS-CoV-2
Язык: Английский
Процитировано
4
Expert Review of Anti-infective Therapy, Год журнала: 2024, Номер 22(7), С. 569 - 577
Опубликована: Июнь 1, 2024
Since the end of 2022, Azvudine was widely used to treat hospitalized coronavirus disease 2019 (COVID-19) patients in China. However, data on real-world effectiveness against severe outcomes and post-COVID-19-conditions (PCC) among infected by acute respiratory syndrome 2 (SARS-CoV-2) Omicron variants limited. This study evaluates COVID-19 during a SARS-CoV-2 BA.5 dominance period.
Язык: Английский
Процитировано
1
Influenza and Other Respiratory Viruses, Год журнала: 2024, Номер 18(9)
Опубликована: Сен. 1, 2024
ABSTRACT Introduction There is still a lack of clinical evidence comprehensively evaluating the effectiveness antiviral treatments for COVID‐19 hospitalized patients. Methods A retrospective cohort study was conducted at Beijing You'An Hospital, focusing on patients treated with nirmatrelvir/ritonavir or azvudine. The employed tripartite analysis—viral dynamics, survival curve analysis, and AI‐based radiological analysis pulmonary CT images—aiming to assess severity pneumonia. Results Of 370 either azvudine as monotherapy, those in group experienced faster viral clearance than (5.4 days vs. 8.4 days, p < 0.001). No significant differences were observed curves between two drug groups. revealed that nirmatrelvir had more severe pneumonia conditions (infection ratio 11.1 5.35, = 0.007). Patients an infection higher 9.2 nearly three times mortality rate compared lower 9.2. Conclusions Our suggests real‐world studies regarding pneumonia, effect significantly superior azvudine, but choice agents not necessarily linked outcomes; admission most important factor determine prognosis. Additionally, our findings indicate AI imaging can be powerful tool predicting patient prognosis guiding decision‐making.
Язык: Английский
Процитировано
1