Favipiravir for the Treatment of Coronavirus Disease 2019 Pneumonia; a Propensity Score-matched Cohort Study
et al., Journal of Infection and Public Health, doi:10.1016/j.jiph.2022.08.011, Nov 2021 (preprint)
PSM retrospective with 1,493 patients, showing significantly improved viral clearance with favipiravir. There were no significant differences in clinical improvement or mortality. Mortality was lower (2.1% vs 3.1%), without statistical significance with the small number of events.
Potential risks of favipiravir include kidney injury1-3, liver injury2-4, and mutagenicity, carcinogenicity, teratogenicity, embryotoxicity, and the creation of dangerous variants5-11.
|
risk of death, 33.3% lower, RR 0.67, p = 0.50, treatment 8 of 387 (2.1%), control 12 of 387 (3.1%), NNT 97, propensity score matching, day 28.
|
|
risk of no clinical improvement, 2.2% higher, RR 1.02, p = 0.73, treatment 26 of 387 (6.7%), control 28 of 387 (7.2%), NNT 194, adjusted per study, inverted to make RR<1 favor treatment, day 28, Cox proportional hazards, propensity score matching, primary outcome.
|
|
days to clinical improvement, 6.2% higher, relative time 1.06, p = 0.07, treatment 387, control 387, propensity score matching.
|
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risk of no viral clearance, 43.9% lower, RR 0.56, p < 0.001, treatment 78 of 387 (20.2%), control 139 of 387 (35.9%), NNT 6.3, propensity score matching.
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| Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates |
1.
Abdulaziz et al., Clinical Features and Prognosis of Acute Kidney Injury in Hospital-Admitted Patients with COVID-19 in Egypt: A Single-Center Experience, Mansoura Medical Journal, doi:10.58775/2735-3990.1433.
2.
Ülger et al., Experimental evaluation of favipiravir (T-705)-induced liver and kidney toxicity in rats, Food and Chemical Toxicology, doi:10.1016/j.fct.2025.115472.
3.
El-Fetouh et al., Experimental Studies on Some Drugs Used in Covid-19 Treatment (Favipiravir and Dexamethasone) in Albino Rats, Journal of Advanced Veterinary Research, 13:10, www.advetresearch.com/index.php/AVR/article/view/1635.
4.
Almutairi et al., Liver Injury in Favipiravir-Treated COVID-19 Patients: Retrospective Single-Center Cohort Study, Tropical Medicine and Infectious Disease, doi:10.3390/tropicalmed8020129.
5.
Zhirnov et al., Favipiravir: the hidden threat of mutagenic action, Journal of microbiology, epidemiology and immunobiology, doi:10.36233/0372-9311-114.
6.
Waters et al., Human genetic risk of treatment with antiviral nucleoside analog drugs that induce lethal mutagenesis: the special case of molnupiravir, Environmental and Molecular Mutagenesis, doi:10.1002/em.22471.
7.
Hadj Hassine et al., Lethal Mutagenesis of RNA Viruses and Approved Drugs with Antiviral Mutagenic Activity, Viruses, doi:10.3390/v14040841.
8.
Shum, C., An investigational study into the drug-associated mutational signature in SARS-CoV-2 viruses, The University of Hong Kong, PhD Thesis, hub.hku.hk/handle/10722/344396.
9.
Shiraki et al., Convenient screening of the reproductive toxicity of favipiravir and antiviral drugs in Caenorhabditis elegans, Heliyon, doi:10.1016/j.heliyon.2024.e35331.
Alattar et al., 30 Nov 2021, retrospective, Qatar, peer-reviewed, median age 46.0, 25 authors, study period 23 May, 2020 - 18 July, 2020, average treatment delay 5.0 days.
Contact: aomrani@hamad.qa.
Favipiravir for the treatment of coronavirus disease 2019 pneumonia; a propensity score-matched cohort study
Journal of Infection and Public Health, doi:10.1016/j.jiph.2022.08.011
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Ethical approval The study was approved by the Institutional Review Board at Hamad Medical Corporation (MRC-01-20-994), with a waiver of informed consent.
Funding The publication of this article was funded by the Qatar National Library. J o u r n a l P r e -p r o o f
Declaration of Interest
None
References
Beigel, Tomashek, Dodd, Mehta, Zingman et al., Remdesivir for the Treatment of Covid-19 -Final Report, N Engl J Med, doi:10.1056/NEJMoa2007764
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Furuta, Komeno, Nakamura, Favipiravir (T-705), a broad spectrum inhibitor of viral RNA polymerase, Proc Jpn Acad Ser B Phys Biol Sci, doi:10.2183/pjab.93.027
Ivashchenko, Dmitriev, Vostokova, Azarova, Blinow et al., AVIFAVIR for Treatment of Patients with Moderate COVID-19: Interim Results of a Phase II/III Multicenter Randomized Clinical Trial, Clin Infect Dis, doi:10.1093/cid/ciaa1176
J O U R N A L P R E, -p r o o f
Kumagai, Murakawa, Hasunuma, Aso, Yuji et al., Lack of effect of favipiravir, a novel antiviral agent, on QT interval in healthy Japanese adults, Int J Clin Pharmacol Ther, doi:10.5414/cp202388
Lagocka, Dziedziejko, Kłos, Pawlik, Favipiravir in Therapy of Viral Infections, J Clin Med, doi:10.3390/jcm10020273
Manabe, Kambayashi, Akatsu, Kudo, Favipiravir for the treatment of patients with COVID-19: a systematic review and meta-analysis, BMC Infect Dis, doi:10.1186/s12879-021-06164-x
Özlüşen, Kozan, Akcan, Kalender, Yaprak et al., Effectiveness of favipiravir in COVID-19: a live systematic review, Eur J Clin Microbiol Infect Dis, doi:10.1007/s10096-021-04307-1
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