Favipiravir's clinical potential for treating Severe Fever with Thrombocytopenia Syndrome (SFTS): A narrative review

Severe Fever with Thrombocytopenia Syndrome (SFTS), an emerging infectious disease first identified in China in 2009, has subsequently been reported in multiple neighboring countries. This disease exhibits high incidence and mortality rates, evolving into a significant public health concern. As a broad-spectrum antiviral agent, favipiravir has demonstrated promising therapeutic potential against SFTS in clinical applications within Japan, positioning itself as a focus of research in this field. This narrative review summarizes the disease characteristics of SFTS and research advances related to favipiravir, with a focus on investigating the drug's therapeutic efficacy and mechanism of action against SFTS. Current evidence indicates that favipiravir not only effectively inhibits SFTS virus replication but may also improve patients' clinical outcomes, offering a novel therapeutic direction for SFTS treatment. This paper comprehensively reviews favipiravir's mechanism of action against SFTSV, along with advances in preclinical and clinical research, while addressing current challenges and future research directions to provide reference for further investigation and clinical application of this drug. However, it should be noted that current clinical experience with favipiravir for the treatment of SFTS remains relatively limited. There is still a lack of robust evidence from large-scale, high-quality randomized controlled trials to definitively establish its efficacy and safety. Furthermore, the molecular mechanisms underlying certain observed side effects (such as elevated uric acid levels) require further investigation to optimize safety.