Ribavirin: Pharmacology, Multiple Modes of Action and Possible Future Perspectives

Nyström, Kristina; Waldenström, J; Tang, Ka-Wei; Lagging, Martin

doi:10.2217/fvl-2018-0166

Cited by 65 publications

(60 citation statements)

References 56 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the past studies, many antiviral drugs have been developed for clinical use to treat millions of human beings worldwide, and some of them have been approved efficiency of severe acute respiratory syndrome (SARS) and the Middle East respiratory syndrome (MERS), such as Ribavirin and LPV/r [14][15][16][17][18]. Ribavirin is a unique guanosine analogue with broad-spectrum activity against many RNA and DNA viruses [19].There are several proposed mechanisms of action, including indirect mechanisms (Enhancement of host T-cell-mediated immunity against viral infection and inhibition of the host enzyme Inosine-5′monophosphate dehydrogenase) and other hypotheses (Direct inhibition of viruses and as an RNA mutagen) [19,20]. LPV/r is a fixed-dose combination medication for the treatment and prevention of human immunodeficiency virus (HIV) / acquired immunodeficiency syndrome (AIDS).…”

Section: Discussionmentioning

confidence: 99%

Effect of combination antiviral therapy on hematological profiles in 151 adults hospitalized with severe coronavirus disease 2019

Yang

Liu

et al. 2020

Pharmacological Research

View full text Add to dashboard Cite

The current diagnosis and medicines approach in coronavirus disease 2019 (COVID-19) does not reflect the heterogeneous characteristics of this disease. This study aims to find a new antiviral combination regimen by investigating the frequency of clinically relevant and objectively identified comorbidities, and the clustering of these clinical syndromes and varying results of treatment with antiviral drugs in patients hospitalized with severe COVID-19. Methods: This study recruited 151 severe COVID-19 infection cases diagnosed in our hospital examination and illustrated the clinical potential during a consecutive 25-day medication period. Potential differences in disease severity and clinical characteristics, hematological profile, and current pharmacologic treatments (single agent, double or triple combinations, and the combined antiviral drugs plus Lianhua Qingwen) among comorbidity clusters were explored. Results: Although disease severity was comparable among three clusters, it was markedly different in terms of laboratory test status. Coagulable abnormality was mainly present in cluster 1 and cluster 2. Other indicators were normal, except for a significant increase of neutrophils presented in cluster 2. Patients showed the most complicated haematological results in cluster 3, including severe coagulation abnormalities, leukocytosis, neutrophilic granulocytosis, and lymphopenia. Our results for the first time suggest that a quadruple combination therapy (Ribavirin, Lopinavir/ritonavir, Umifenovir, and Lianhua Qingwen) can be considered as a preferred treatment approach to severe COVID-19 patients. After treatment, abnormal coagulation and leukocyte had markedly improved with a better prognosis. Conclusion: This study expands the understanding of the co-occurrence of combination therapy in patients with COVID-19, which provides the probability of developing novel combined therapy. Furthermore, explore clinical trials of variable antivirus treatments based on subgroup analyses or on using subgroups in the selection criteria would be the next step.

show abstract

Section: Discussionmentioning

confidence: 99%

Effect of combination antiviral therapy on hematological profiles in 151 adults hospitalized with severe coronavirus disease 2019

Yang

Liu

et al. 2020

Pharmacological Research

View full text Add to dashboard Cite

show abstract

“…In addition, ribavirin is contraindicated during pregnancy, due to its potential teratogenicity demonstrated in many animal models studied [120]. Controversially, several evidences demonstrate that the teratogenicity effect of ribavirin associated with humans is not significant, as observed when the Ribavirin Pregnancy Registry was established in 2003 [121].…”

Section: Treatment Strategiesmentioning

confidence: 99%

SARS-CoV, MERS-CoV and SARS-CoV-2 infections in pregnancy and fetal development

Silva

Costa

et al. 2020

Journal of Gynecology Obstetrics and Human Reproduction

View full text Add to dashboard Cite

Recently, in China, in 2019, a new type of disease has arisen caused by a new strain of coronavirus, the SARS-CoV-2 virus, considered extremely worrying due to its high infectivity power and the easy ability to spread geographically. For patients in general, the clinical features resulting from respiratory syndromes can trigger an asymptomatic condition. However, 25 % of patients infected by SARS-CoV-2 can progress to severity. Pregnant women are an unknown field in this complex process, and although they have symptoms similar to non-pregnant women, some points should be considered, such as complications during pregnancy and postpartum. Thus, the aim of this study was to understand the consequences of pregnancy and fetal development, caused by infections by the SARS-CoV, MERS-CoV and SARS-CoV-2 viruses. Among the aforementioned infections, MERS-CoV seems to be the most dangerous for newborns, inducing high blood pressure, pre-eclampsia, pneumonia, acute renal failure, and multiple organ failure in mother. This also causes a higher occurrence of emergency cesarean deliveries and premature births, in addition, some deaths of mothers and fetuses were recorded. Meanwhile, SARS-CoV and SARS-CoV-2 appear to have less severe symptoms. Furthermore, although a study found the ACE2 receptor, used by SARS-CoV-2, widely distributed in specific cell types of the maternal-fetal interface, there is no evidence of vertical transmission for any of the coronaviruses. Thus, the limited reported obstetric cases alert to the need for advanced life support for pregnant women infected with coronaviruses and to the need for further investigation for application in clinical practice.

show abstract

“…Ribavirin which is a guanosine analogue has been demonstrated to have antiviral activity against a broad range of DNA and RNA viruses [ 26 ]. In clinical practice, it has been mostly used in the treatment of respiratory syncytial virus infection, chronic hepatitis C infection, viral hemorrhagic fevers, and several other severe and life-threatening viral infections [ 26 ]. In a prospective cohort study on the Hong Kong population, initial SARS patients were given antibiotics for pneumonia and oseltamivir for influenza infection [ 27 ].…”

Section: Treatment Options For Sars-cov Infectionmentioning

confidence: 99%

Treatment Options for Severe Acute Respiratory Syndrome, Middle East Respiratory Syndrome, and Coronavirus Disease 2019: a Review of Clinical Evidence

Hoang

Anh²

2020

Infect Chemother

View full text Add to dashboard Cite

Coronaviruses have caused serious Severe Acute Respiratory Syndrome (SARS), Middle East Respiratory Syndrome (MERS), and Coronavirus Disease 2019 (COVID-19) outbreaks, and only remdesivir has been recently indicated for the treatment of COVID-19. In the line of therapeutic options for SARS and MERS, this study aims to summarize the current clinical evidence of treatment options for COVID-19. In general, the combination of antibiotics, ribavirin, and corticosteroids was considered as a standard treatment for patients with SARS. The addition of this conventional treatment with lopinavir/ritonavir, interferon, and convalescent plasma showed potential clinical improvement. For patients with MERS, ribavirin, lopinavir/ritonavir, interferon, and convalescent plasma were continuously recommended. However, a high-dose of corticosteroid was suggested for severe cases only. The use of lopinavir/ritonavir and convalescent plasma was commonly reported. There was limited evidence for the effect of corticosteroids, other antiviral drugs like ribavirin, and favipiravir. Monoclonal antibody of tocilizumab and antimalarial agents of chloroquine and hydroxychloroquine were also introduced. Among antibiotics for infection therapy, azithromycin was suggested. In conclusion, this study showed the up-to-date evidence of treatment options for COVID-19 that is helpful for the therapy selection and the development of further guidelines and recommendations. Updates of ongoing clinical trials and observational studies may confirm the current findings.

show abstract

Ribavirin: Pharmacology, Multiple Modes of Action and Possible Future Perspectives

Cited by 65 publications

References 56 publications

Effect of combination antiviral therapy on hematological profiles in 151 adults hospitalized with severe coronavirus disease 2019

Effect of combination antiviral therapy on hematological profiles in 151 adults hospitalized with severe coronavirus disease 2019

SARS-CoV, MERS-CoV and SARS-CoV-2 infections in pregnancy and fetal development

Treatment Options for Severe Acute Respiratory Syndrome, Middle East Respiratory Syndrome, and Coronavirus Disease 2019: a Review of Clinical Evidence

Contact Info

Product

Resources

About