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At the end of 2022, with the full liberalization of China's new crown epidemic control, the winter epidemic will sweep the country in the
next few months.
According to national data, if the new crown breaks out in the short term, it is necessary to provide 200,000-250,000 ICU beds for the severe/critical patients among them1
, resulting in serious overload of the hospital.
Patients of any age can be hospitalized due to severe illness due to COVID-19, with nearly 40% of hospitalized patients under the age of 55, according to the CDC in the United States2
.
In addition, a small number of patients with underlying medical conditions or other risk factors may still develop severe disease, so special attention needs to be paid to such "vulnerable groups" in hospitalized patients!
Faveravir is the first drug approved for potential efficacy against the novel coronavirus in China during the epidemic, and evidence of its efficacy and safety in hospitalized patients has been recently published, as interpreted below
.
PIONEER study: Early treatment of faviravir predicts more favorable clinical outcomes in hospitalized patients with suspected/confirmed COVID-19
Research protocol
A multicenter, open-label, randomized controlled study conducted from May 2020 to May 2021, including 499 patients with suspected or confirmed COVID-19 who were admitted to hospitals in the United Kingdom, Brazil and Mexico, were randomized in a 1:1 basis, with the study group receiving faviravir + standard care (SoC) and the control group receiving only standard care
.
To assess the efficacy and safety of faviravir in hospitalised patients, the primary endpoint was time to recovery, and secondary endpoints included survival without mechanical ventilation, mortality, and safety
.
Patients with suspected or confirmed COVID-19 included: positive RT-PCR test; or the clinical feature is fever, and at least 1 respiratory symptom meets it, if the clinical features cannot be judged, imaging examination is required to show pulmonary infiltrates;
Moderate-to-severe patients were predominantly included: 83% of patients scored 4 to 5 on a 7-point scale, and these patients required oxygen
.
Standard care: modified according to local guidelines, with glucocorticoids, remdesivir, and tocilizumab;
Faviravir group + standard care: faviravir treatment, 1800 mg Po BID on day 1, 800 mg bid on days 2-10; Standard treatment is the same as above
.
Study results
➢ There was a trend towards a reduction in the risk of mechanical ventilation and death in the faviravir-treated group
The risk of mechanical ventilation and the risk of death in the faviravir-treated group were reduced by 24% and 26%, respectively, with a decreasing trend
.
➢Faviravir treatment significantly accelerated the recovery of inpatients under 60 years of age, and the recovery rate improved significantly on day 4
Treatment with faviravir significantly reduced recovery time (HR 1.
35 [95% CI 1.
06–1.
72]).
➢Faviravir treatment significantly improved the mechanically ventilation-free survival rate of hospitalized patients under 60 years of age by 66%.
Treatment with faviravir significantly improved survival without mechanical ventilation (HR 0·34 [95% CI 0.
13–0.
85]).
➢ Faviravir treatment did not increase the risk of adverse events
The incidence of serious adverse events in faviravir + SoC vs SoC was similar (11% vs 11%, p=0.
87).
summary
➢Early treatment of suspected/confirmed hospitalized patients by faviravir can accelerate recovery, improve prognosis, and relieve pressure on hospital operations;
➢ There is a trend towards a decrease in the risk of mechanical ventilation and death;
➢ Significant improvement in recovery time and survival without mechanical ventilation in hospitalized patients under 60 years of age
.
END
References
1.
Gang Lu,et al.
Front.
Med.
doi.
org/10.
1007/s11684-022-0981-7.
2.
Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19)— United States, February 12– March 16, 2020
3.
Shah PL, et al.
Lancet Respir Med .
2022 Dec 14; S2213-2600(22)00412-X.
