Опыт применения азоксимера бромида для профилактики острых респираторных заболеваний и COVID-19 у взрослых из группы повышенного риска инфицирования (медицинских работников «красной зоны»): метаанализ контролируемых клинических исследований

Abstract

Aim: meta-analysis of the clinical trials with the use of Azoximer bromide for the prevention of acute respiratory infections (ARI) and the novel coronavirus infection COVID-19 to systematically assess the epidemiological effectiveness of Azoximer bromide in adults at a higher risk of contracting the infection — the "red zone" healthcare workers. Patients and Methods: the search for clinical trials of Azoximer bromide was performed in the Russian-language and international sources. To identify controlled trials, the authors used such electronic databases as PubMed, Embase, Cochrane Library, eLIBRARY.RU, Scientific Electronic Library, and CyberLeninka. The following keywords were used for conducting the search: Azoximer bromide, respiratory tract infection, COVID-19, prevention, and adults (through May 2022), heathcare workers, medical personnel. Also, clinical trial reports on the use of medications containing Azoximer bromide as the main active ingredient were requested from the manufacturing companies. Publications and reports were selected based on the eligibility criteria. In particular, the assessment included such a parameter as ARI and COVID-19 morbidity. Pointwise estimates of effects were found for conducting meta-analysis which were calculated using odds ratios (OR). Results: out of the total 64 publications and reports involving over 5060 adults, three clinical trials using Azoximer bromide were selected. These trials had a relatively uniform design and matched the eligibility criteria. The selected trials included 1141 adults 18–69 years old. The treatment group comprised 718 subjects who received Azoximer bromide, and the control group included 423 individuals. The use of Azoximer bromide had the effect of reducing morbidity associated with ARI and COVID-19 in the groups at a higher risk of contracting infection (healthcare workers). For the subjects receiving Azoximer bromide, an OR of not getting sick from ARI and COVID-19 was 3.02 (95% confidence interval (CI) 2.14–3.89); in the control group an OR of not getting sick from COVID-19 was 2.65 (95% CI 1.53–3.77). The authors noted that Azoximer bromide had a good safety profile in all trials. Conclusion: the epidemiological effectiveness of Azoximer bromide was demonstrated in the groups at a higher risk of contracting the infection (healthcare workers), as proven by the significant reduction of ARI and COVID-19 morbidity. Thus, this drug can be recommended for the prevention of the studied infections during seasonal epidemics. KEYWORDS: acute respiratory infections, COVID-19, meta-analysis, Azoximer bromide, healthcare workers. FOR CITATION: Omarova Kh.G., Ploskireva A.A., Agarkova I.A., Gorelov A.V. Experience with the use of Azoximer bromide for the prevention of acute respiratory infections and COVID-19 in adults from the group with a higher risk of contracting the infection ("red zone" healthcare workers): meta-analysis of controlled clinical trials. Russian Medical Inquiry. 2022;6(11):635–642 (in Russ.). DOI: 10.32364/2587-6821- 2022-6-11-635-642.