对COVID-19的药物重新定位:来自随机控制的适应性平台试验和活体系统性审查的当前证据
Yolanda Augustin1, Henry M Staines1, Thirumalaisamy P Velavan2,3
1Institute of Infection and Immunity, St George's University of London, London, UK.
药物重新使用加速了COVID-19治疗开发. 虽然像皮质类固醇这样的一些疗法显示出希望,但像雷梅西维尔这样的其他疗法有相互矛盾的证据,需要进一步研究最佳干预措施.
科学领域:
- 药理学和传染病的研究
- 临床试验设计 临床试验设计
- 证据综合 证据综合
背景情况:
- 随着COVID-19大流行,全球都在努力重新调整药物的用途,以获得有效的治疗方法.
- 适应性平台试验和活体系统审查对于合成新出现的临床数据至关重要.
研究的目的:
- 审查COVID-19治疗药物重定向的情况.
- 突出治疗干预的共识,争议和未来研究方向的领域.
主要方法:
- 对最近发表的关于COVID-19治疗方法的文献进行分析.
- 综合了自适应平台试验和系统审查的发现.
- 确定关键的治疗类别和正在进行的调查.
主要成果:
- 皮质类固醇和IL-6受体对抗剂改善了住院患者的治疗结果;吸入的布德索尼德有助于社区的康复.
- 雷梅西维尔的疗效受到争议,主要试验关于死亡率和恢复的结果相互矛盾.
- 包括empagliflozin,artesunate,imatinib,infliximab,favipiravir,ivermectin和fluvoxamine在内的众多药物正在进行研究.
结论:
- 针对COVID-19的治疗干预需要仔细考虑干预时间和临床上有意义的终点.
- 持续的研究对于澄清各种重用药物的作用和优化治疗策略至关重要.
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