Effectiveness of Favipiravir on Nonsevere, Early-Stage COVID-19 in Japan: A Large Observational Study Using the COVID-19 Registry Japan

Tsuzuki, Shinya; Hayakawa, Kayoko; Doi, Yohei; Shinozaki, Tomohiro; Uemura, Yukari; Matsunaga, Nobuaki; Terada, Mari; Suzuki, Setsuko; Asai, Yasufumi; Yamada, Gen; Saito, Sho; Shibata, Taro; Kondo, Masashi; Izumi, Kazuo; Hojo, Masayuki; Mizoue, Tetsuya; Yokota, Kazuhisa; Nakamura‐Uchiyama, Fukumi; Saito, Fumitake; Sugiura, Wataru; Ohmagari, Norio

doi:10.1007/s40121-022-00617-9

Cited by 8 publications

(6 citation statements)

References 30 publications

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“…To our knowledge, currently, a few randomized controlled trials and a large observational study demonstrated the absence of its effectiveness in the examined endpoints consisting of time of viral shedding, hospitalization rate, mechanical ventilator requirement, and mortality rate. [24][25][26] The fact that the Thailand Ministry of Public Health reported that new infections decreased to 1500 cases per day in Bangkok and surrounding areas after the "early testing and early treatment" policy was implemented suggests the potential efficacy of this strategy. Another possible indication of the success of this initiative is that the Siriraj Favipiravir Clinic was able to close within 5 weeks of opening due to the decrease in new cases to a level that could be successfully managed by the normal healthcare system.…”

Section: Discussionmentioning

confidence: 99%

Early diagnosis by antigen test kit and early treatment by antiviral therapy: An ambulatory management strategy during COVID-19 crisis in Thailand

et al. 2022

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This study aimed to assess the clinical characteristics of patients who registered at the Siriraj Favipiravir Clinic and to share our experiences in this comparatively unique clinical setting.This retrospective study included patients who registered at the Siriraj Favipiravir Clinic during August 11, 2021 to September 14, 2021. Included adult patients were those with severe acute respiratory syndrome coronavirus 2 (coronavirus disease 2019 ) infection confirmed by antigen test kit (ATK) or real-time reverse transcription-polymerase chain reaction, no favipiravir contraindication, no prior COVID-19 treatment, and not receiving care from another medical facility. Demographic data and outcomes were collected and analyzed.Of the 1168 patients (mean age: 44.8 ± 16.4 years, 55.7% female) who registered at the clinic, 117 (10%) did not meet the treatment criteria, and 141 (12%) patients did not pick up their medication. One-third of patients had at least 1 symptom that indicated severe disease. Higher proportion of unvaccinated status (56.7% vs 47.5%, P = .005), higher proportion of persons with risk factors for disease progression (37.7% vs 31.3%, P = .028), and longer duration between the date of clinic registration and the date of positive diagnostic test (3 vs 2 days, P = .004) were significantly more commonly observed in the severe disease group compared to the nonsevere disease group. The duration between symptom onset and the date of clinic registration was significantly longer in the real-time reverse transcription-polymerase chain reaction group than in the ATK group (6 vs 4 days, P < .001). Most patients (90.0%) had completed favipiravir treatment regimen. The improvement and mortality rates were 86.7% and 1.2%, respectively.COVID-19 severity is associated with vaccination status, baseline risk factors, and timing between disease detection and treatment. The use of ATK influences patients to seek treatment significantly earlier in ambulatory setting. Our early diagnosis and antiviral treatment strategy yielded favorable results in an outpatient setting during a COVID-19 outbreak in Thailand.

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Section: Discussionmentioning

confidence: 99%

Early diagnosis by antigen test kit and early treatment by antiviral therapy: An ambulatory management strategy during COVID-19 crisis in Thailand

et al. 2022

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“…Министерство здравоохранения Российской Федерации; 2022. 15 Инструкция по медицинскому применению лекарственного препарата омепразол. https://grls.minzdrav.gov.ru/Grls_View_ v2.aspx?routingGuid=1f929759-b209-4086-8223-ead3658b4df5 16 https://www.whocc.no/atc_ddd_index/?code=A02BC01 койко-дней, для ГИБП и циклофосфамида -3,5 СД/100 пациентов, в 2021 г.…”

Section: результаты и обсуждениеunclassified

“…Среди всех препаратов ВР ЛПП, назначавшихся пациентам с СOVID-19, в том числе для терапии сопутствующих заболеваний, наиболее часто используемым ЛП был омепразол, его потребление в 2022 г. в 1,9 раза превысило 100 DDD/100 койко-дней. Рекомендуемая стандартная доза омепразола в инструкции по медицинскому применению препарата 15 для большинства показаний и DDD, указанная на сайте ВОЗ 16 , составляет 20 мг/сут. Омепразол получали 1112 (89%) пациентов, большинство из них (864 человека) -в дозе 20 мг 2 раза/сут (перорально 862, парентерально 2), 52 (4,7%) пациента -в дозе 40 мг 2 раза/сут (парентерально) и только 196 (17,6%) в дозе 20 мг/сут (перорально).…”

Section: результаты и обсуждениеunclassified

Analysis of the Consumption of Medicinal Products Associated with a High Risk of Drug-Induced Liver Injury in Patients with COVID-19

Petrov,

Ryazanova,

Tokareva

2024

Bezopasnost' i risk farmakoterapii

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INTRODUCTION. The risk of liver damage correlates with the severity of COVID-19. However, a growing number of studies have shown an association between liver function impairment and combinations of medicinal products used to treat COVID-19.AIM. The study aimed to analyse the annual consumption of medicinal products associated with a high risk of drug-induced liver injury (DILI) used as part of combination therapy in COVID-19 patients and to review a number of medication administration records in order to develop measures to prevent DILI.MATERIALS AND METHODS. The study used the ATC/DDD methodology to study consumption data for 2020, 2021, and 2022 and analysed a sample of 1250 inpatient medical records and medication administration records of COVID-19 patients treated in a Volgograd region hospital converted into a COVID-19 care centre. For genetically engineered biologicals and cyclophosphamide, which were lacking DDDs, the authors calculated the volume of consumption using the average dose per treatment course. The authors identified medicines capable of causing clinically apparent liver damage (according to the LiverTox database and Russian clinical practice guidelines) and/or elevated liver enzymes in ≥1% of patients (according to safety reports).RESULTS. The study found that 28% of the medicinal products used in combination for inpatient treatment of COVID-19 were associated with a high risk of DILI. In 2020, 2021, and 2022, the total consumption of medicinal products associated with a high risk of DILI was 342.3, 425.3, and 402.3 DDDs per 100 bed days, and the total consumption of genetically engineered biologicals (administered as a single dose) and cyclophosphamide was 3.5, 16.9, and 29.7 average course doses per 100 patients, respectively. According to the selective analysis of medical records, 19.8% (247/1250) reported concomitant use of 5 or more medicinal products associated with a high risk of DILI, which increased the risk of adverse drug interactions leading to DILI. In 2022, the most prescribed medicinal products with a high risk of DILI were omeprazole (188.7 DDDs per 100 bed days), non-steroidal anti-inflammatory drugs and paracetamol (54.4 DDDs per 100 bed days), atorvastatin (46.2 DDDs per 100 bed days), levofloxacin (26.4 DDDs per 100 bed days), ceftriaxone (20.5 DDDs per 100 bed days), favipiravir (17.3 DDDs per 100 bed days), and genetically engineered biologicals (24.0 DDDs per 100 bed days).CONCLUSIONS. To reduce the risk of DILI in COVID-19 patients admitted to infectious disease units, including the risk of DILI due to drug interactions, it is necessary to limit the use of hepatotoxic antibacterial agents, proton-pump inhibitors, and non-steroidal anti-inflammatory drugs, or consider alternative medicinal products with a lower risk of hepatotoxicity.

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“…A separate study carried out in Japan found over 80% of individuals with mild and moderate cases recovered after 14 days, whereas only 60% of COVID‐19 patients with severe symptoms recovered following treatment with favipiravir [ 150 ]. Thus, favipiravir was concluded to be effective against non‐severe COVID‐19 but has subsequently been deemed non‐essential for treatment of COVID‐19 [ 80 ].…”

Section: Viral Replicationmentioning

confidence: 99%

A guide to COVID‐19 antiviral therapeutics: a summary and perspective of the antiviral weapons against SARS‐CoV‐2 infection

et al. 2022

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Antiviral therapies are integral in the fight against SARS‐CoV‐2 (i.e. severe acute respiratory syndrome coronavirus 2), the causative agent of COVID‐19. Antiviral therapeutics can be divided into categories based on how they combat the virus, including viral entry into the host cell, viral replication, protein trafficking, post‐translational processing, and immune response regulation. Drugs that target how the virus enters the cell include: Evusheld, REGEN‐COV, bamlanivimab and etesevimab, bebtelovimab, sotrovimab, Arbidol, nitazoxanide, and chloroquine. Drugs that prevent the virus from replicating include: Paxlovid, remdesivir, molnupiravir, favipiravir, ribavirin, and Kaletra. Drugs that interfere with protein trafficking and post‐translational processing include nitazoxanide and ivermectin. Lastly, drugs that target immune response regulation include interferons and the use of anti‐inflammatory drugs such as dexamethasone. Antiviral therapies offer an alternative solution for those unable or unwilling to be vaccinated and are a vital weapon in the battle against the global pandemic. Learning more about these therapies helps raise awareness in the general population about the options available to them with respect to aiding in the reduction of the severity of COVID‐19 infection. In this ‘A Guide To’ article, we provide an in‐depth insight into the development of antiviral therapeutics against SARS‐CoV‐2 and their ability to help fight COVID‐19.

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Effectiveness of Favipiravir on Nonsevere, Early-Stage COVID-19 in Japan: A Large Observational Study Using the COVID-19 Registry Japan

Cited by 8 publications

References 30 publications

Early diagnosis by antigen test kit and early treatment by antiviral therapy: An ambulatory management strategy during COVID-19 crisis in Thailand

Early diagnosis by antigen test kit and early treatment by antiviral therapy: An ambulatory management strategy during COVID-19 crisis in Thailand

Analysis of the Consumption of Medicinal Products Associated with a High Risk of Drug-Induced Liver Injury in Patients with COVID-19

A guide to COVID‐19 antiviral therapeutics: a summary and perspective of the antiviral weapons against SARS‐CoV‐2 infection

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