Safety Of Favipiravir Research Articles

Фавипиравир как потенциальное средство противодействия при COVID-19

Favipiravir is a broad-spectrum antiviral agent, an analogue of purine nucleosides, licensed as an anti-influenza drug in Japan. Like other analogs of nucleosides, favipiravir acts as a prodrug, and undergoes an intracellular phosphoribosylation to be an active form, favipiravir ribofuranosyl-5'-triphosphate. The metabolite competitively inhibits the activity of RNA polymerase of RNA viruses and prevents virus replication by incorporating into the viral RNA, acting as a chain terminator. It possesses selective or virus-specific intracellular action and low cytotoxicity. Favipiravir inhibits viral RNA synthesis by terminating chain elongation, which re-duces the likelihood of mutations and the emergence of resistant virus strains. Favipiravir causes a significant decrease in pro-inflammatory cytokines levels, which enhances the antiviral effect. Favipiravir demonstrated antiviral activity against a broad spectrum of RNA viruses, such as influenza A, B and C viruses, Ebola virus, Lassa virus, rabies, etc. In 2020, as part of screening testing of antiviral drugs, including favipiravir, it was shown in vitro antiviral activity against 2019-nCoV with better efficacy and selectivity compared to ribavirin. More than 10 clinical trials have been initiated to study the effectiveness of favipiravir for the treatment of mild to moderate COVID-19. A fixed loading and maintenance dose of 3200/1200 mg and 3600/1600 mg was used. The results showed a better clinical effect with earlier elimination of coronavirus, regression of computed tomographic changes and the need for mechanical ventilation in the favipiravir treat-ment groups compared with lopinavir/ritonavir, Arbidol and other drugs. In a Russian phase II/III clinical study of efficacy and safety of favipiravir (Avifavir)(1600/600 mg or 1800/800 mg 2 times a day) vs standard treatment in patients with moderate COVID-19, favipiravir showed virus clearance within 4 days in 62,5% of patients, safety and good tolerance. Favipiravir is included in the Russian guidelines for the treatment of COVID-19 and is the only approved oral med-ication for the treatment of moderate COVID-19 to date.

A Systematic Review of the Efficacy and Safety of Favipiravir (Avigan) for the Treatment of Novel COVID-19 Infections

Since the emergence of SARS-CoV-2 infection in Wuhan, China, in December 2019, the spread has caused COVID19 disease in over 8.1 million people and more than 439 thousand deaths across the globe as on 16th June 2020. Absence of any particular cure or vaccine lead the health care system to treat the patients with the existing potential antiviral drugs. Recently, Favipiravir, a potential RdRp inhibitor of SARS-COV-2 sheds the ray of hope for treating COVID-19 patients efficiently.

Systematic review and meta-analysis of effectiveness and safety of favipiravir in the management of novel coronavirus (COVID-19) patients.

Multiple options are being tried for the management of 2019-nCoV infection since its pandemic started. Favipiravir (FPV) is one of drugs, which is also being tried for the management of 2019-nCoV infection. The present study aimed to evaluate the efficacy and safety of FPV in published literature. Comparative randomized or nonrandomized controlled clinical trials comparing FPV to the standard of care (SOC)/control or other antiviral agent/combinations were included. A total of 12 databases were searched and identify four studies which were further used for final analysis. The data analysis was done as pooled prevalence using a random effect model by “RevMan manager version 5.4.1 and “R” software. The point estimate, odds ratio (OR) with 95% confidence interval (CI) was calculated for dichotomous data. In the present study, the marginal beneficial effect was seen in the FPV group in overall clinical improvement comparison to SOC/control, i.e., (4 studies, log OR [95% CI] (−0.19 [−0.51, 0.13]). However, in all other outcomes, it was found to be comparable to the SOC/control arm namely “clinical improvement on day 7–10” (3 studies, OR [95% CI] 1.63 [1.07, 2.48]) while “clinical improvement on day 10–14” (3 studies, OR [95% CI] 1.37 [0.24, 7.82]) and viral negativity was seen (4 studies, OR [95% CI] 1.91 [0.91, 4.01]). No difference in efficacy was found between FPV versus lopinavir/ritonavir or arbidol groups. Regarding adverse effects, except for the occurrence of rash (higher in the FPV group), safety was comparable to SOC. In our study, there was a marginal difference between the FPV and the SOC arm in terms of “clinical improvement” on day 7–10 or 10–14, and “virological negativity” on day 10–14.” However, some benefit was observed in a few studies, but it was also comparable to the control drugs or SOC.