Oral favipiravir for patients with delayed SARS-CoV-2 viral RNA clearance: a case series

Fu, Dian; Cao, Ruiyuan; Zhao, Lei; Li, Wei; Zhong, Wu; Wen, Jinsheng

doi:10.1186/s13054-020-03288-5

Cited by 8 publications

(7 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Favipiravir was reported to have an EC 50 of 61.88 μM against SARS-CoV-2 in Vero E6 cells . Several clinical trials have preliminarily demonstrated its efficacy and safety (Cai et al, 2020;Fu et al, 2020;Ivashchenko et al, 2021), with large-scale clinical trials currently underway (Appili Therapeutics Inc., 2020; PRINCIPLE, 2021). Favipiravir has been authorized for emergency COVID-19 treatment in several countries, such as Turkey, India, and Russia.…”

Section: Inhibitors Of Sars-cov-2 Rdrpmentioning

confidence: 99%

Mechanism of Action of Small-Molecule Agents in Ongoing Clinical Trials for SARS-CoV-2: A Review

Zhao¹,

Li²,

Zhong³

2022

Front. Pharmacol.

Self Cite

View full text Add to dashboard Cite

Since the first reports from December 2019, COVID-19 caused an overwhelming global pandemic that has affected 223 countries, seriously endangering public health and creating an urgent need for effective drugs to treat SARS-CoV-2 infection. Currently, there is a lack of safe, effective, and specific therapeutic drugs for COVID-19, with mainly supportive and symptomatic treatments being administered to patients. The preferred option for responding to an outbreak of acute infectious disease is through drug repurposing, saving valuable time that would otherwise be lost in preclinical and clinical research, hastening clinical introduction, and lowering treatment costs. Alternatively, researchers seek to design and discover novel small-molecule candidate drugs targeting the key proteins in the life cycle of SARS-CoV-2 through an in-depth study of the infection mechanism, thus obtaining a number of candidate compounds with favorable antiviral effects in preclinical and clinical settings. There is an urgent need to further elucidate the efficacy and mechanism of action of potential anti-SARS-CoV-2 small-molecule drugs. Herein, we review the candidate small-molecule anti-SARS-CoV-2 drugs in ongoing clinical trials, with a major focus on their mechanisms of action in an attempt to provide useful insight for further research and development of small-molecule compounds against SARS-CoV-2 infection.

show abstract

Section: Inhibitors Of Sars-cov-2 Rdrpmentioning

confidence: 99%

Mechanism of Action of Small-Molecule Agents in Ongoing Clinical Trials for SARS-CoV-2: A Review

Zhao¹,

Li²,

Zhong³

2022

Front. Pharmacol.

Self Cite

View full text Add to dashboard Cite

show abstract

“…The lack of clinical benefit in our report is consistent with findings from previous studies. [11][12][13][14] On the other hand, earlier SARS-CoV-2 clearance with favipiravir had been reported in some previous studies, [8,9,15,16] but not in others. [17,18] Higher SARS-CoV-2 viral loads in the respiratory tract have been associated with an increased risk of transmission and also increased risk of severe disease and mortality.…”

Section: (Which Was Not Certified By Peer Review) Preprintmentioning

confidence: 98%

Favipiravir for the Treatment of Coronavirus Disease 2019; a propensity score-matched cohort study

Alattar¹,

Abdalla²,

Abdallah³

et al. 2021

Preprint

View full text Add to dashboard Cite

BackgroundWe investigated clinical outcomes of favipiravir in patients with COVID-19 pneumonia.MethodsPatients who between 23 May 2020 and 18 July 2020 received ≥24 hours of favipiravir were assigned to the favipiravir group, while those who did not formed the non-favipiravir group. The primary outcome was 28-day clinical improvement, defined as two-category improvement from baseline on an 8-point ordinal scale. Propensity scores (PS) for favipiravir therapy were used for 1:1 matching. Cox regression was used to examine associations with the primary endpoint.ResultsThe unmatched cohort included 1,493 patients, of which 51.7% were in the favipiravir group, and 48.3% were not receiving supplemental oxygen at baseline. Favipiravir was started within a median of 5 days from symptoms onset. Significant baseline differences between the two unmatched groups existed, but not between the PS-matched groups (N = 774). After PS-matching, there were no significant differences between the two groups in the proportion with 28-day clinical improvement (93.3% versus 92.8%, P 0.780), or 28-day all-cause mortality (2.1% versus 3.1%, P 0.360). Favipiravir was associated with more viral clearance by day 28 (79.8% versus 64.1%, P <0.001). In the adjusted Cox proportional hazards model, favipiravir therapy was not associated 28-day clinical improvement (adjusted hazard ratio 0.978, 95% confidence interval 0.862 –1.109, P 0.726). Adverse events were common in both groups, but the 93.9% were Grades 1–3.ConclusionFavipiravir therapy for COVID-19 pneumonia is well tolerated but is not associated with an increased likelihood of clinical improvement or reduced all-cause mortality by 28 days.

show abstract

“…Since the EC50 of T-705 is higher in COVID-19 compared to influenza it is recommended to administer 1800 mg loading dose BID on day 1 followed by 800 mg BID from day 2 to a maximum duration of 14 days [14]. Another regimen described in the literature consists of two doses of 1600 mg on day 1 followed by 600 mg twice daily on days 2-10 or until SARS-CoV-2 RNA negative but it needs further evaluation [15]. In adult patients with mild-to-moderate coronavirus disease 2019 a loading dose of 1800 mg favipiravir plus standard supportive care followed by 800 mg BID plus standard treatment until day 14 led to suspension of viral shedding by day 5 of treatment and reduced duration of clinical signs and symptoms [16].…”

Section: Clinical Application Of Favipiravirmentioning

confidence: 99%

A review on the mechanism of action of favipiravir and hydroxychloroquine in COVID-19

Pavlova¹,

Hristova²,

Uzunova³

et al. 2021

Res Rev Insights

View full text Add to dashboard Cite

The global COVID-19 pandemic, caused by the severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2), spread rapidly across the globe. The lack of available therapies was an essential condition to repurpose available medicines for the treatment or prevention of that worrisome condition. It was our aim to summarize the available knowledge about the mechanism of action of the antirheumatic drugs chloroquine/hydroxychloroquine and the antiviral drug favipiravir. Further, the concomitant therapeutic potential of both drugs is discussed. The multiple mechanisms of action of CQ/HCQ as well as their immunomodulatory properties are still under investigation in COVID-19 treatment. The nucleoside analogue favipiravir is rapidly metabolized in host cells which disrupts viral synthesis and leads to mutagenesis. Clinical trials become available that provide evidence of the beneficial effect of concomitant use of both drugs in mild-COVID-19 patients. Simultaniously, side effects like QTc prolongation or teratogenicity pose risk to extensive community application. Future well designed, large randomized clinical trials are awaited to determine the role if any of those medications in COVID-19 therapy.

show abstract

Oral favipiravir for patients with delayed SARS-CoV-2 viral RNA clearance: a case series

Cited by 8 publications

References 3 publications

Mechanism of Action of Small-Molecule Agents in Ongoing Clinical Trials for SARS-CoV-2: A Review

Mechanism of Action of Small-Molecule Agents in Ongoing Clinical Trials for SARS-CoV-2: A Review

Favipiravir for the Treatment of Coronavirus Disease 2019; a propensity score-matched cohort study

A review on the mechanism of action of favipiravir and hydroxychloroquine in COVID-19

Contact Info

Product

Resources

About