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

Prakash, Ajay; Singh, Harvinder; Kaur, Hardeep; Semwal, Ankita; Sarma, Phulen; Bhattacharyya, Anusuya; Dhibar, Deba Prasad; Medhi, Bikash

doi:10.4103/ijp.ijp_998_20

Cited by 25 publications

(5 citation statements)

References 14 publications

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“…Presently used therapeutic agents for the management of COVID-19 include steroid therapy [ 8 ]; remdesivir [ 9 ]; chloroquine; hydroxychloroquine [ 10 - 12 ]; favipiravir [ 13 ]; ivermectin [ 14 ]; convalescent plasma therapy (CPT) [ 15 ]; and adjunctive agents including zinc, vitamin D [ 16 ], folic acid [ 17 ], and anticoagulants [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Comparative Safety and Efficacy of Remdesivir Versus Remdesivir Plus Convalescent Plasma Therapy (CPT) and the Effect of Timing of Initiation of Remdesivir in COVID-19 Patients: An Observational Study From North East India

Sharma¹,

Deb²,

Sarma³

et al. 2021

Cureus

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IntroductionAs per the COVID-19 treatment guidelines of India, remdesivir and convalescent plasma therapy (CPT) are indicated in moderate and severe patients. In this study, we have evaluated the comparative safety and efficacy of remdesivir versus remdesivir CPT combination and effect of early versus late initiation of remdesivir. Materials and methodsA hospital-based observational study was conducted among hospitalized moderate and severe COVID-19 patients treated with either remdesivir and/or CPT as per national guidelines. Response to therapy was evaluated in terms of mortality, mechanical ventilation requirement, ICU requirement, and safety. Results and observationsA total of 95 moderate and severe COVID-19 patients on remdesivir (n=35) or remdesivir + CPT combination (n=60) were included. Both the remdesivir and remdesivir + CPT groups were comparable in terms of baseline characteristics, however, proportion of patients with baseline serum creatinine >1.5 was higher in the remdesivir group. No difference was seen between both the groups in terms of mortality, mechanical ventilation requirement, ICU requirement, and safety parameters in the overall moderate and severe COVID-19 populations and when each of these severity categories (moderate and severe) were analyzed separately. Early initiation (<9 days from symptom onset) of remdesivir was associated with better treatment outcome in terms of mortality and requirement of ICU. Post-therapy shortness of breath and LFTs (liver function tests) elevation was more in the late initiation of remdesivir group, which may be due to the lack of efficacy and subsequent disease progression or a direct effect of the drug. The beneficial effect of remdesivir was maintained even after adjustment for important prognostic factors and baseline imbalances (age, sex, disease severity, CPT use, and serum creatinine level). ConclusionsEarly initiation of remdesivir was associated with clinical benefit in terms of mortality and mechanical ventilation requirement. However, addition of convalescent plasma therapy as an additional therapeutic modality to remdesivir was not found to be beneficial.

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Section: Introductionmentioning

confidence: 99%

Comparative Safety and Efficacy of Remdesivir Versus Remdesivir Plus Convalescent Plasma Therapy (CPT) and the Effect of Timing of Initiation of Remdesivir in COVID-19 Patients: An Observational Study From North East India

Sharma¹,

Deb²,

Sarma³

et al. 2021

Cureus

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“…Two studies reported no effect of favipiravir on the need for ICU transfer compared to controls [ 60 , 63 ]. Nausea, vomiting, diarrhea, and elevated uric acid and liver transaminases were the most commonly reported adverse events of favipiravir [ 59 , [61] , [62] , [63] , [64] , [65] ].…”

Section: Resultsmentioning

confidence: 99%

The Saudi Critical Care Society practice guidelines on the management of COVID-19 in the ICU: Therapy section

Alhazzani¹,

Alshahrani²,

Alshamsi³

et al. 2022

Journal of Infection and Public Health

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Background The rapid increase in coronavirus disease 2019 (COVID-19) cases during the subsequent waves in Saudi Arabia and other countries prompted the Saudi Critical Care Society (SCCS) to put together a panel of experts to issue evidence-based recommendations for the management of COVID-19 in the intensive care unit (ICU). Methods The SCCS COVID-19 panel included 51 experts with expertise in critical care, respirology, infectious disease, epidemiology, emergency medicine, clinical pharmacy, nursing, respiratory therapy, methodology, and health policy. All members completed an electronic conflict of interest disclosure form. The panel addressed 9 questions that are related to the therapy of COVID-19 in the ICU. We identified relevant systematic reviews and clinical trials, then used the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach as well as the evidence-to-decision framework (EtD) to assess the quality of evidence and generate recommendations. Results The SCCS COVID-19 panel issued 12 recommendations on pharmacotherapeutic interventions (immunomodulators, antiviral agents, and anticoagulants) for severe and critical COVID-19, of which 3 were strong recommendations and 9 were weak recommendations. Conclusion The SCCS COVID-19 panel used the GRADE approach to formulate recommendations on therapy for COVID-19 in the ICU. The EtD framework allows adaptation of these recommendations in different contexts. The SCCS guideline committee will update recommendations as new evidence becomes available.

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“…Coronavirus disease caused unprecedented challenges to the healthcare 14 . The result of Pairwise meta-analysis shown that lopinavir-ritonavir (0.8319) is the best intervention for treating COVID-19 patients followed by standard care (0.8319), placebo (0.4794), remdesivir (0.2723) and other antivirals (0.0234).…”

Section: Discussionmentioning

confidence: 99%

Pairwise and Network Meta-Analysis of Antiviral and other Treatment Efficacy in Covid-19 Patients

Singh P,

Upadhyay A. K,

Karthikeyan R

et al. 2023

IJPHRD

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A total of 77 literatures till November 2020 were screened regarding various interventions to treat COVID-19 patients, among which 16 and 15 studies fulfilling predefined exclusion and inclusion criteria were subjected to Pairwise and Network meta-analysis respectively. In Pairwise meta-analysis, the recovery rate of treatment with Lopinavir/Ritonavir versus other antiviral (OR= 0. 0381, CI= 0.0021-0.6870), placebo (OR= 0.6592, CI= 0.4207-1. 0329), Remdesivir (OR= 0.5286, CI= 0.3915-0.7137) and standard care (OR= 0.9787, CI= 0.8523-1.1238) in fixed and random effect model with 95% confidence limit found statistically significant protection than those of all other treatment. In Network meta-analysis, recovery estimates sizes of treatment, in reference with other antivirals 1.0000 (0.9917, 1.0000) shows less risk with treatment Standard care 0.7811 (0.6696, 0.8417), Remdesivir 0.7717 (0.6491, 0.8144), Lopinavir/ Ritonavir 0.7801 (0.6701, 0.8473), Placebo 0.7219 (0.6178, 0.7836).

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

Cited by 25 publications

References 14 publications

Comparative Safety and Efficacy of Remdesivir Versus Remdesivir Plus Convalescent Plasma Therapy (CPT) and the Effect of Timing of Initiation of Remdesivir in COVID-19 Patients: An Observational Study From North East India

Comparative Safety and Efficacy of Remdesivir Versus Remdesivir Plus Convalescent Plasma Therapy (CPT) and the Effect of Timing of Initiation of Remdesivir in COVID-19 Patients: An Observational Study From North East India

The Saudi Critical Care Society practice guidelines on the management of COVID-19 in the ICU: Therapy section

Pairwise and Network Meta-Analysis of Antiviral and other Treatment Efficacy in Covid-19 Patients

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