目的:系统检索关于洛匹那韦/利托那韦用于病毒感染性疾病的文献并分析,为新型冠状病毒肺炎(COVID-19)的治疗提供参考。方法:计算机检索Pubmed、Embase、Cochrane Central Register of Controlled Trials(CENTRAL)、中国知网(CNKI)、维...目的:系统检索关于洛匹那韦/利托那韦用于病毒感染性疾病的文献并分析,为新型冠状病毒肺炎(COVID-19)的治疗提供参考。方法:计算机检索Pubmed、Embase、Cochrane Central Register of Controlled Trials(CENTRAL)、中国知网(CNKI)、维普数据库、万方数据库,检索时限均为建库至2020年2月22日,对符合纳入标准的文献的主要结果进行描述性分析。结果:初筛文献2036篇,筛选后最终纳入洛匹那韦/利托那韦用于病毒感染性疾病文献392篇。其中用于获得性免疫缺陷综合征(AIDS)研究244篇,用于严重急性呼吸综合征(SARS)研究2篇,用于中东呼吸综合征(MERS)研究4篇,用于COVID-19研究2篇。洛匹那韦/利托那韦用于AIDS疗效确切。用于SARS的2个研究均显示“洛匹那韦/利托那韦+利巴韦林+糖皮质激素”的治疗方案有效。动物实验显示洛匹那韦/利托那韦与干扰素β1b单独使用或联合用于MERS有效,个案报道推荐“洛匹那韦/利托那韦联合干扰素β1b”用于MERS的治疗方案。洛匹那韦/利托那韦与阿比多尔对比用于COVID-19的研究,未发现洛匹那韦/利托那韦和阿比多尔具有改善症状或缩短呼吸道标本病毒核酸转阴时间的作用。结论:洛匹那韦/利托那韦用于AIDS疗效确切,用于SARS的治疗方案有效。但是,用于COVID-19缺少高质量研究证据支持。安全性方面,腹泻、恶心等胃肠道反应为洛匹那韦/利托那韦短期给药的主要不良反应;合并用药时需要考虑药物的相互作用,用药剂量建议按照诊疗方案。展开更多
The coronavirus disease(COVID-19)pandemic has led to a global struggle to cope with the sheer numbers of infected persons,many of whom require intensive care support or eventually succumb to the illness.The outbreak i...The coronavirus disease(COVID-19)pandemic has led to a global struggle to cope with the sheer numbers of infected persons,many of whom require intensive care support or eventually succumb to the illness.The outbreak is managed by a combination of disease containment via public health measures and supportive care for those who are affected.To date,there is no specific anti-COVID-19 treatment.However,the urgency to identify treatments that could turn the tide has led to the emergence of several investigational drugs as potential candidates to improve outcome,especially in the severe to critically ill.While many of these adjunctive drugs are being investigated in clinical trials,professional bodies have attempted to clarify the setting where the use of these drugs may be considered as off-label or compassionate use.This review summarizes the clinical evidence of investigational adjunctive treatments used in COVID-19 patients as well as the recommendations of their use from guidelines issued by international and national organizations in healthcare.展开更多
文摘目的:系统检索关于洛匹那韦/利托那韦用于病毒感染性疾病的文献并分析,为新型冠状病毒肺炎(COVID-19)的治疗提供参考。方法:计算机检索Pubmed、Embase、Cochrane Central Register of Controlled Trials(CENTRAL)、中国知网(CNKI)、维普数据库、万方数据库,检索时限均为建库至2020年2月22日,对符合纳入标准的文献的主要结果进行描述性分析。结果:初筛文献2036篇,筛选后最终纳入洛匹那韦/利托那韦用于病毒感染性疾病文献392篇。其中用于获得性免疫缺陷综合征(AIDS)研究244篇,用于严重急性呼吸综合征(SARS)研究2篇,用于中东呼吸综合征(MERS)研究4篇,用于COVID-19研究2篇。洛匹那韦/利托那韦用于AIDS疗效确切。用于SARS的2个研究均显示“洛匹那韦/利托那韦+利巴韦林+糖皮质激素”的治疗方案有效。动物实验显示洛匹那韦/利托那韦与干扰素β1b单独使用或联合用于MERS有效,个案报道推荐“洛匹那韦/利托那韦联合干扰素β1b”用于MERS的治疗方案。洛匹那韦/利托那韦与阿比多尔对比用于COVID-19的研究,未发现洛匹那韦/利托那韦和阿比多尔具有改善症状或缩短呼吸道标本病毒核酸转阴时间的作用。结论:洛匹那韦/利托那韦用于AIDS疗效确切,用于SARS的治疗方案有效。但是,用于COVID-19缺少高质量研究证据支持。安全性方面,腹泻、恶心等胃肠道反应为洛匹那韦/利托那韦短期给药的主要不良反应;合并用药时需要考虑药物的相互作用,用药剂量建议按照诊疗方案。
文摘The coronavirus disease(COVID-19)pandemic has led to a global struggle to cope with the sheer numbers of infected persons,many of whom require intensive care support or eventually succumb to the illness.The outbreak is managed by a combination of disease containment via public health measures and supportive care for those who are affected.To date,there is no specific anti-COVID-19 treatment.However,the urgency to identify treatments that could turn the tide has led to the emergence of several investigational drugs as potential candidates to improve outcome,especially in the severe to critically ill.While many of these adjunctive drugs are being investigated in clinical trials,professional bodies have attempted to clarify the setting where the use of these drugs may be considered as off-label or compassionate use.This review summarizes the clinical evidence of investigational adjunctive treatments used in COVID-19 patients as well as the recommendations of their use from guidelines issued by international and national organizations in healthcare.
