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

Hu, Cheng-Yi; Cui, Wen-Shuai; Lei, Yi; Tang, Yu-Wen; Zhang, Yan-Yan; Su, Qi-Min; Peng, Fang; Zeng, Yun-Fei; Song, Jia-Lin; Luo, Cheng-Na; Zhou, Yan; Li, Xin-Yan; Zhao, Zhu-Xiang

doi:10.2147/idr.s433186

Cited by 4 publications

(3 citation statements)

References 31 publications

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“…The initial literature search yielded 84 articles, of which 25 considered eligible for full-text review following title and abstract screening. After the full-text review, 12 studies were excluded due to control type and insufficient data, resulting in the inclusion of 13 articles [20][21][22][23][24][25][26][27][28][29][30][31][32] involving 4949 patients for the metaanalysis. All included studies were retrospective cohort designs, and the mean patient age across the studies ranged from 14 to 66.2.…”

Section: Search Resultsmentioning

confidence: 99%

“…A total of 10 studies 20,21,[24][25][26][27][28][29][30][31] involving 4672 patients reported mortality rates among COVID-19 patients treated with azvudine or Paxlovid. The pooled estimate indicated no significant difference in mortality rate between the azvudine and Paxlovid groups (OR = 0.84, 95% CI: 0.59-1.21; p = 0.37, I 2 = 55%, GRADE certainty: moderate) (Figure 2).…”

Section: Mortality Ratementioning

confidence: 99%

“…Data are available online for the included studies. [20][21][22][23][24][25][26][27][28][29][30][31][32]…”

Section: Conflict Of Interest Statementmentioning

confidence: 99%

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Azvudine versus Paxlovid in COVID‐19: A systematic review and meta‐analysis

Amani,

Amani

2024

Reviews in Medical Virology

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This systematic review and meta‐analysis aimed to compare the effectiveness and safety of azvudine versus nirmatrelvir/ritonavir (Paxlovid) in treating coronavirus disease 2019 (COVID‐19). The researchers conducted searches on PubMed, Cochrane Library, Web of Science, medRxiv, and Google Scholar until January 2024. The Cochrane risk of bias tool was utilised to evaluate the quality of the included studies, and data analysis was performed using Comprehensive Meta‐Analysis software. Thirteen studies, including 4949 patients, were analysed. The meta‐analysis results showed no significant difference between the azvudine and Paxlovid groups in terms of mortality rate (odds rate [OR] = 0.84, 95% confidence interval [CI]: 0.59–1.21), negative polymerase chain reaction (PCR) conversion time (standard mean difference [SMD] = 1.52, 95% CI: −1.07–4.11), and hospital stay (SMD = −0.39, 95% CI: −1.12–0.33). However, a significant difference was observed between the two groups in terms of intensive care unit admission (OR = 0.42, 95% CI: 0.23–0.75) and the need for mechanical ventilation (OR = 0.61, 95% CI: 0.44–0.86) in favour of azvudine. The incidence of adverse events in the azvudine group was significantly lower (OR = 0.66, 95% CI: 0.43–0.99). The certainty of evidence was rated as low and moderate. Azvudine and Paxlovid demonstrated similar effectiveness in reducing mortality rates, negative PCR conversion time and hospital stay. However, azvudine showed better effectiveness in improving other outcomes. Regarding the level of certainty of evidence, further research is needed to validate or challenge these results.

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Section: Search Resultsmentioning

confidence: 99%

Section: Mortality Ratementioning

confidence: 99%

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Azvudine versus Paxlovid in COVID‐19: A systematic review and meta‐analysis

Amani,

Amani

2024

Reviews in Medical Virology

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Effectiveness of azvudine against severe outcomes among hospitalized COVID-19 patients in Xinjiang, China: a single-center, retrospective, matched cohort study

Kapar,

Xie,

Guo

et al. 2024

Expert Review of Anti-infective Therapy

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Efficacy and Safety of Azvudine in Patients With COVID‐19 in China: A Meta‐Analysis of Observational Studies

Dong,

Zhang,

et al. 2024

Clinical Respiratory J

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BackgroundAzvudine (FNC) is a novel small molecule antiviral drug for treating COVID‐19 that is available only on the Chinese market. Despite being recommended for treating COVID‐19 by the Chinese guidelines, its efficacy and safety are still unclear. This study aimed to evaluate the protective effect of FNC on COVID‐19 outcomes and its safety.MethodsWe followed the PRISMA 2020 guidelines and searched the PubMed, Embase, Web of Science, Scopus, and China National Knowledge Infrastructure (CNKI) databases to evaluate studies on the effectiveness of FNC in treating COVID‐19 in China, focusing on mortality and overall outcomes. Additionally, its impact on the length of hospital stay (LOHS), time to first nucleic acid negative conversion (T‐FNANC), and adverse events was evaluated. The inclusion criterion was that the studies were published from July 2021 to April 10, 2024. This study uses the ROBINS‐I tool to assess bias risk and employs the GRADE approach to evaluate the certainty of the evidence.ResultsThe meta‐analysis included 24 retrospective studies involving a total of 11 830 patients. Low‐certainty evidence revealed no significant difference in mortality (OR = 0.91, 95% CI: 0.76–1.08) or LOHS (WMD = −0.24, 95% CI: −0.83 to 0.35) between FNC and Paxlovid in COVID‐19 patients. Low‐certainty evidence shows that the T‐FNANC was longer (WMD = 1.95, 95% CI: 0.36–3.53). Compared with the Paxlovid group, low‐certainty evidence shows the FNC group exhibited a worse composite outcome (OR = 0.77, 95% CI: 0.63–0.95) and fewer adverse events (OR = 0.63, 95% CI: 0.46–0.85). Compared with supportive treatment, low certainty shows FNC significantly reduced the mortality rate in COVID‐19 patients (OR = 0.61, 95% CI: 0.51–0.74) and decreased the composite outcome (OR = 0.67, 95% CI: 0.50–0.91), and very low certainty evidence shows significantly decreased the T‐FNANC (WMD = −4.62, 95% CI: −8.08 to −1.15). However, in very low certainty, there was no significant difference in LOHS (WMD = −0.70, 95% CI: −3.32 to 1.91) or adverse events (OR = 1.97, 95% CI: 0.48–8.17).ConclusionsFNC appears to be a safe and potentially effective treatment for COVID‐19 in China, but further research with larger, high‐quality studies is necessary to confirm these findings. Due to the certainty of the evidence and the specific context of the studies conducted in China, caution should be exercised when considering whether the results are applicable worldwide.Trial RegistrationPROSPERO number: CRD42024520565

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

Cited by 4 publications

References 31 publications

Azvudine versus Paxlovid in COVID‐19: A systematic review and meta‐analysis

Azvudine versus Paxlovid in COVID‐19: A systematic review and meta‐analysis

Effectiveness of azvudine against severe outcomes among hospitalized COVID-19 patients in Xinjiang, China: a single-center, retrospective, matched cohort study

Efficacy and Safety of Azvudine in Patients With COVID‐19 in China: A Meta‐Analysis of Observational Studies

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