Influenza virus and coronaviruses continue to cause pandemics across the globe. We know have a greater understanding of their function. Unfortunately the number of drugs in our armory to defend us against them are inadequate. This may require us to think about what mechanisms to address. We now review the biological properties of these viruses, their genetic evolution and antiviral therapies that can be used or have been attempted. We will describe several classes of drugs such as serine protease inhibitors, heparin, and heparan sulphate receptor inhibitors, chelating agents, immunomodulators and many others. We also briefly describe some of the drug repurposing efforts which have taken place in an effort to rapidly identify molecules to treat patients with COVID-19. While we have a heavy emphasis on the past and present efforts, we also provide some thoughts about what we need to do to prepare for respiratory viral threats in the future.
The aim of the study was to carry out meta-analysis of randomized controlled trials in order to combine the results of clinical trials on Triazavirin® (Riamilovir) efficacy in the etiotropic therapy of acute respiratory viral infection. Materials and methods. The studies included 435 patients with a confirmed diagnosis of acute respiratory viral infection or ARVI (with laboratory confirmed absence of influenza virus antigens). The research was carried out in 27 centers. In studies, patients were divided into 3 groups in a 1:1:1 ratio (a total of 145 people per group). Each study included a group taking 100 mg of the medication 5 times a day, a group taking 250 mg of the medication 3 times a day and a placebo 2 times a day, as well as a group taking a placebo 5 times a day. The analysis was carried out in accordance with the PRISMA principles regarding the quality of information presentation on the results of systematic reviews and meta-analyzes of works evaluating the effects of medical interventions. Results. The conducted meta-analysis showed that the use of Triazavirin® (Riamilovir) has a statistically significantly effects on the severity of clinical symptoms in patients with ARVI. The performed meta-analysis confirmed reliable associations between the use of Triazavirin® (Riamilovir) in both doses and the chance of a persistent improvement in clinical symptoms on the 5th day of therapy. The meta-analysis also confirmed the statistical significance of the clinical effects of Riamilovir by such indicators as the area under the curve «point on the scale showing the severity of the condition in a patient with ARVI in relation to time», the proportion of patients with complete alleviation of all symptoms by the end of the 5th day from the start of therapy. Conclusion. The clinical trials proved that the use of Triazavirin® (Riamilovir) is effective both in the initial and in the late stages of the disease, therefore, the drug can be used in the initial therapy of adult patients with respiratory diseases of viral etiology.
A model of brain ischemia induced by staged ligation of the left and right common carotid arteries has been developed in experiments on rats. The use to this model led to reduction of animal mortality. On days 2-5 after the second ligature, the animals lost weight, the level of their CNS vulnerability increased, the volume of perceived information reduced, adaptation to environmental conditions and reproduction of conditioned reflexes were disordered. Focal and diffuse destructive changes in the nerve and glia cells were found in the cerebral cortex, hippocampus, and thalamic nuclei. The severity of disorders in the blood supply to the brain depended on the interval between ligation of the carotid arteries. This recommends this model for evaluation of the efficiency of drugs of various pharmacological groups.
The activity of the antimetabolic drug Riamilovir (Triazavirin®) was studied on a model of SARS-CoV-2 infection on Syrian hamsters. Infectious process was caused by the intranasal administration of the virus accumulated in the Vero-B culture with a concentration of 4.25×104 TCID50, in a volume of 26 µl/hamster. The effects of the drug at a dose of 20 mg/kg intraperitoneally daily in the midst of the infectious process were traced to accelerate the clearance of the virus in the lungs, prevent body weight loss and the severity of pulmonary edema, as well as preserve the mass of the spleen. The protective effects of Riamilovir on the structure of the lungs and brain are shown, it is suggested that the drug has the ability to penetrate the blood-brain barrier. It was concluded that Riamilovir has antiviral activity against SARS-CoV-2.
The aim of the study was to carry out a meta-analysis of randomized clinical trials in order to combine the results of clinical trials on Triazavirin® (Riamilovir) efficacy in etiotropic therapy of influenza.Materials and methods. The analysis was carried out in accordance with the PRISMA principles regarding the quality of information presentation on the results of systematic reviews and meta-analyzes of works assessing medical interventions. The study included 471 patients with a confirmed diagnosis of influenza (with laboratory confirmed presence of influenza virus antigens).Results. The conducted meta-analysis showed that the use of Triazavirin® (Riamilovir) has a statistically significant effect on the severity of clinical symptoms in patients with influenza, therefore Riamilovir can be used in the initial therapy of adult patients with influenza.Conclusion. Clinical studies have shown that the use of Triazavirin® (Riamilovir) is effective both in the initial and late stages of the disease, and therefore Riamilovir can be used in the treatment of adult patients with respiratory diseases of viral etiology, in particular, those diagnosed with influenza. The meta-analysis of the collected data showed that therapy with Triazavirin® (Riamilovir) has statistically significant advantages in various aspects both in comparison with the placebo group and with the Tamiflu® (Oseltamivir) group.
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