Azvudine versus Paxlovid for oral treatment of COVID-19 in Chinese patients with pre-existing comorbidities

Dian, Yating; Meng, Yu; Sun, Yuming; Deng, Guangtong; Zeng, Furong

doi:10.1016/j.jinf.2023.05.012

Cited by 23 publications

(28 citation statements)

References 8 publications

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“…7 As our study mainly included severe COVID-19 patients in China, the limited efficacy of nirmatrelvir-ritonavir is not surprising. 3,8 While Ma et al found a faster time to nucleic acid negative conversion in patients receiving nirmatrelvir-ritonavir compared to those receiving Azvudine, 1 it did not entirely negate our findings that support the better clinical benefit of Azvudine. 3 Evaluating a drug's effectiveness requires clinical data, rather than piecing together several basic articles to make a speculation solely based on its antiviral effect.…”

contrasting

confidence: 62%

Evaluate clinical effectiveness of Azvudine with data rather than speculation

Liu

Shen

et al. 2023

Journal of Medical Virology

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contrasting

confidence: 62%

Evaluate clinical effectiveness of Azvudine with data rather than speculation

Liu

Shen

et al. 2023

Journal of Medical Virology

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“…As the rst launched Chinese oral anti-COVID-19 drug [8], Azvudine exhibited antiviral activity effectively against coronavirus in preliminary clinical trials [2,4,9,10,11]. Meanwhile, several retrospective cohort studies suggested that Azvudine showed more effectiveness in hospitalized COVID-19 patients compared with Nirmatrelvir-ritonavir and Paxlovid in terms of composite disease progression outcome [12,13]. In this retrospective analysis, the crude all-cause death rate was 2.82 per 1000 person-days in patients who received Azvudine vs. 4.52 per 1000 person-days in the control group, suggesting that Azvudine administration caused a lower mortality rate.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness and Optimal Timing of Azvudine in COVID-19 Patients: A Multi-center Retrospective Study in Beijing, China

Han

Xiao

Wang

et al. 2023

Preprint

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Background: Clinical effectiveness of Azvudine against coronavirus infection and optimal time for initiation of Azvudine treatment to hospitalized COVID-19 patients are not fully understood. Methods: This is a multi-center retrospective cohort study, and five clinical centers of the Chinese People’s Liberation Army General Hospital participated. From omicron pandemics, 6218 hospitalized patients confirmed with COVID-19 from December 10, 2022, to February 20, 2023, were retrieved for this study. After exclusions and propensity score matching , 428 Azvudine recipients and 428 controls were included with a follow-up of 28 days. The primary outcome was all-cause mortality during 28 days of hospitalization, and the secondary outcome was the proportion of patients with clinical improvement up to day 28. Results: The Azvudine group had a lower crude all-cause death rate when compared to the control group (2.82 per 1000 person-days vs. 4.52 per 1000 person-days; HR: 0.63, 95%CI: 0.40-1.00; P=0.038). Notably, the incidence rate of clinical improvement outcome was significantly higher in patients who received Azvudine within 5 days from the onset of symptoms, compared to the control group (Median days: 9 vs. 10; P=0.007). Subgroup analyses showed that chronic lung disease and corticosteroid treatment acted as protective factors (P=0.010; P=0.050). Conclusions: Clinical effectiveness of Azvudine in improving all-cause mortality in COVID-19 patients was seen, and initiation of Azvudine treatment within 5 days of the onset of symptoms was found to be significant. Additionally, the findings revealed the protective effect of Azvudine in COVID-19 patients with chronic lung disease.

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“…If the patient returned to the hospital for follow-up visit within 1 month after discharge, the follow-up time was extended to the date of the first follow-up visit. The median (IQR) overall length of hospital stay was 9 (6)(7)(8)(9)(10)(11)(12)(13)(14) days. The overall median (IQR) follow-up period was 12 (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) days.…”

Section: Patient Cohort and Study Designmentioning

confidence: 99%

“…The median (IQR) overall length of hospital stay was 9 (6)(7)(8)(9)(10)(11)(12)(13)(14) days. The overall median (IQR) follow-up period was 12 (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) days.…”

Section: Patient Cohort and Study Designmentioning

confidence: 99%

Comparison of Azvudine and Nirmatrelvir/Ritonavir and Combined Use in Patients with COVID-19

Hu,

Cui,

Lei

et al. 2023

IDR

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To compare the effectiveness of azvudine and nirmatrelvir/ritonavir for the treatment of coronavirus disease . Patients and Methods: We conducted a retrospective analysis of data from 576 patients with COVID-19, comprising 195 patients without antiviral therapy, 226 patients treated with azvudine, 114 patients treated with nirmatrelvir/ritonavir, and 41 patients were treated with azvudine and nirmatrelvir/ritonavir concurrently. We compared their symptoms, mortality rates, and the length and cost of hospitalization.Results: The incidence of symptoms was similar in patients treated with azvudine and in those treated with nirmatrelvir/ritonavir. However, among patients experiencing weakness, the duration of weakness was significantly shorter in the azvudine group than in the nirmatrelvir/ ritonavir group (P=0.029). Mortality did not differ significantly between the azvudine group and the nirmatrelvir/ritonavir group (18.14% vs.10.53%, P=0.068). Among "severe patients", the mortality rate was markedly lower in patients treated with nirmatrelvir/ritonavir than in patients treated with azvudine (16.92% vs.32.17%, P=0.026). In patients with hepatic insufficiency, those treated with nirmatrelvir/ritonavir had substantially lower mortality than those treated with azvudine (15.09% vs.34.25%, P=0.016). In addition, patients treated with nirmatrelvir/ ritonavir had longer hospital stays (P=0.002) and higher hospital costs (P<0.001) than those receiving azvudine. Compared with patients treated with nirmatrelvir/ritonavir or azvudine alone, patients taking nirmatrelvir/ritonavir and azvudine concurrently had no significant improvement in survival (P>0.05), length of stay (P>0.05), or hospital costs (P>0.05). Conclusion: Azvudine is recommended for patients with non-severe COVID-19 with weakness. Nirmatrelvir/ritonavir is recommended for patients with severe COVID-19, to reduce mortality, and it could be the best choice for patients with hepatic insufficiency. The concurrent use of nirmatrelvir/ritonavir and azvudine in patients with COVID-19 could be not recommended.

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Azvudine versus Paxlovid for oral treatment of COVID-19 in Chinese patients with pre-existing comorbidities

Cited by 23 publications

References 8 publications

Evaluate clinical effectiveness of Azvudine with data rather than speculation

Evaluate clinical effectiveness of Azvudine with data rather than speculation

Effectiveness and Optimal Timing of Azvudine in COVID-19 Patients: A Multi-center Retrospective Study in Beijing, China

Comparison of Azvudine and Nirmatrelvir/Ritonavir and Combined Use in Patients with COVID-19

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