The Need for Antiviral Drugs for Pandemic Coronaviruses From a Global Health Perspective.
The Need for Antiviral Drugs for Pandemic Coronaviruses From a Global Health Perspective.
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DOI：
10.3389/fmed.2020.596587
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发表时间：
2020
影响因子：
3.9
通讯作者：
Doggett JS
中科院分区：
文献类型：
--
作者：
Villamagna AH;Gore SJ;Lewis JS;Doggett JS
由SARS-CoV-2引起的呼吸衰竭已导致广泛的死亡率，迫切需要有效的治疗方法，并长期需要抗病毒药物来应对未来出现的冠状病毒。呼吸道病毒的药物治疗在很大程度上是不成功的，除了流感病毒的早期治疗，这缩短了症状的持续时间，并防止密切接触者感染。在COVID-19大流行迅速演变的情况下，美国大部分实验性治疗的临床试验都集中在疾病过程的后期阶段。在世界范围内，最有影响力的药物，瑞德西韦和地塞米松在ACTT-1，RECOVERY和Solidarity中的临床研究已经研究了住院患者。在美国，不到一半的临床试验研究了口服药物，大多数是在病毒载量已经下降的疾病阶段在医院进行的。呼吸道病毒治疗的有限成功和COVID-19的病毒动力学表明，对大流行性冠状病毒具有最大影响的抗病毒疗法将是口服给药，耐受性良好，靶向高度保守的病毒蛋白或宿主-冠状病毒相互作用，并且可以在世界各地有效使用，包括资源贫乏的环境。我们研究了呼吸道病毒感染的治疗和当前的COVID-19临床试验，为有效的抗病毒治疗和预防未来出现的冠状病毒提供框架，并呼吁关注持续临床前药物发现的必要性。
Respiratory failure due to SARS-CoV-2 has caused widespread mortality, creating an urgent need for effective treatments and a long-term need for antivirals for future emergent coronaviruses. Pharmacotherapy for respiratory viruses has largely been unsuccessful with the exception of early treatment of influenza viruses, which shortens symptom duration and prevents infection in close contacts. Under the rapidly evolving circumstances of the COVID-19 pandemic, most clinical trials of experimental treatments in the United States have focused on later stages of the disease process. Worldwide, the clinical studies of the most impactful drugs, remdesivir and dexamethasone in ACTT-1, RECOVERY, and Solidarity, have studied hospitalized patients. Less than half of clinical trials in the U.S. have investigated oral agents, and the majority have taken place in hospitals at a disease stage where the viral load is already decreasing. The limited success of treatments for respiratory viruses and the viral dynamics of COVID-19 suggest that an antiviral therapy with the greatest impact against pandemic coronaviruses would be orally administered, well-tolerated, target a highly conserved viral protein or host-coronavirus interaction and could be used effectively throughout the world, including resource-poor settings. We examine the treatment of respiratory viral infections and current clinical trials for COVID-19 to provide a framework for effective antiviral therapy and prevention of future emergent coronaviruses and call attention to the need for continued preclinical drug discovery.
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DOI：
10.1056/nejmoa2022926
发表时间：
2020-11-19
期刊：
The New England journal of medicine
影响因子：
--
作者：
RECOVERY Collaborative Group;Horby P;Mafham M;Linsell L;Bell JL;Staplin N;Emberson JR;Wiselka M;Ustianowski A;Elmahi E;Prudon B;Whitehouse T;Felton T;Williams J;Faccenda J;Underwood J;Baillie JK;Chappell LC;Faust SN;Jaki T;Jeffery K;Lim WS;Montgomery A;Rowan K;Tarning J;Watson JA;White NJ;Juszczak E;Haynes R;Landray MJ
通讯作者：
Landray MJ
DOI：
10.1056/nejmoa2029849
发表时间：
2021-01-21
期刊：
The New England journal of medicine
影响因子：
--
作者：
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通讯作者：
BLAZE-1 Investigators
影响因子：
120.7
作者：
Li, Ling;Zhang, Wei;Liu, Zhong
通讯作者：
Liu, Zhong
影响因子：
56.9
作者：
Kissler, Stephen M.;Tedijanto, Christine;Lipsitch, Marc
通讯作者：
Lipsitch, Marc
影响因子：
158.5
作者：
Ikematsu, Hideyuki;Hayden, Frederick G.;Uehara, Takeki
通讯作者：
Uehara, Takeki