Journal
EXPERT REVIEW OF ANTI-INFECTIVE THERAPY
Volume 20, Issue 2, Pages 267-278Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1080/14787210.2021.1961579
Keywords
Antiviral drugs; COVID-19; randomized controlled trials; efficacy; safety; systematic review; network meta-analysis
Ask authors/readers for more resources
The study found no evidence supporting the use of any antiviral drugs for COVID-19 treatment, but cautioned against interpreting the results due to limited evidence, calling for more RCTs to establish a stronger evidence base.
Background To better inform clinical practice, we summarized the findings from randomized controlled trials (RCTs) of antivirals for COVID-19. Methods We systematically searched for literature up to September 2020, and included English-language publications of RCTs among hospitalized COVID-19 patients. We conducted network meta-analysis combining results of both the direct and indirect comparisons of interventions. The efficacy outcomes were clinical progression, all-cause mortality, and viral clearance, and safety outcomes were diarrhea, nausea, and vomiting. We generated treatment rankings (best to worst) and summarized rank probabilities using rankogram. Results We included 15 RCTs (14,418 patients) from 7,237 retrieved citations. There was no evidence for efficacy of the assessed antivirals compared with placebo/no treatment or with another antiviral for all efficacy outcomes. Lopinavir (400 mg)/ritonavir (100 mg) significantly increased diarrhea, nausea, and vomiting compared with placebo/no treatment and other antivirals, and was ranked worst for these outcomes, while triazavirin (250 mg), baloxavir marboxil (80 mg), and remdesivir (100 mg - 10 days) ranked best, respectively. Conclusions and relevance The available evidence does not support the use of any antiviral drugs for COVID-19. Cautious interpretations of the findings are, however, advised considering the paucity of the evidence. More RCTs are needed for a stronger evidence base.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available