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All Studies   Meta Analysis    Recent:   

Efficacy and Safety of Azvudine in Patients With COVID‐19 in China: A Meta‐Analysis of Observational Studies

Dong et al., The Clinical Respiratory Journal, doi:10.1111/crj.13798, PROSPERO CRD42024520565
Jul 2024  
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Mortality 39% Improvement Relative Risk Death/mechanical ventil.. 33% Azvudine for COVID-19  Dong et al.  META ANALYSIS c19early.org Favorsazvudine Favorscontrol 0 0.5 1 1.5 2+
Azvudine for COVID-19
44th treatment shown to reduce risk in July 2023
 
*, now with p = 0.000057 from 22 studies.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,800+ studies for 95 treatments. c19early.org
Meta analysis of 24 studies with 11,830 COVID-19 patients in China, showing significantly lower mortality, lower combined mortality/ventilation/ICU admission, and faster viral clearance with azvudine compared to SOC. In studies comparing with paxlovid, there were fewer adverse events with azvudine, but a longer time to first nucleic acid negative conversion.
4 meta analyses show significant improvements with azvudine for mortality1-4, mechanical ventilation1, improvement1, and viral clearance1,3,4.
Currently there are 22 azvudine for COVID-19 studies, showing 36% lower mortality [21‑48%], 31% lower ventilation [7‑48%], 47% lower ICU admission [5‑70%], and 43% lower hospitalization [-85‑82%].
risk of death, 39.0% lower, OR 0.61, p < 0.001, RR approximated with OR.
death/mechanical ventilation/ICU, 33.0% lower, OR 0.67, p = 0.009, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Dong et al., 12 Jul 2024, China, peer-reviewed, 7 authors, trial PROSPERO CRD42024520565. Contact: yunaliu@126.com.
This PaperAzvudineAll
Efficacy and Safety of Azvudine in Patients With COVID‐19 in China: A Meta‐Analysis of Observational Studies
Tao Dong, Wentao Zhang, Tingting Wu, Yongxiang Ge, Qi Yang, Jia Xu, Yuna Liu
The Clinical Respiratory Journal, doi:10.1111/crj.13798
Background: Azvudine (FNC) is a novel small molecule antiviral drug for treating COVID-19 that is available only on the Chinese market. Despite being recommended for treating COVID-19 by the Chinese guidelines, its efficacy and safety are still unclear. This study aimed to evaluate the protective effect of FNC on COVID-19 outcomes and its safety. Methods: We followed the PRISMA 2020 guidelines and searched the PubMed, Embase, Web of Science, Scopus, and China National Knowledge Infrastructure (CNKI) databases to evaluate studies on the effectiveness of FNC in treating COVID-19 in China, focusing on mortality and overall outcomes. Additionally, its impact on the length of hospital stay (LOHS), time to first nucleic acid negative conversion (T-FNANC), and adverse events was evaluated. The inclusion criterion was that the studies were published from July 2021 to April 10, 2024. This study uses the ROBINS-I tool to assess bias risk and employs the GRADE approach to evaluate the certainty of the evidence. Results: The meta-analysis included 24 retrospective studies involving a total of 11 830 patients. Low-certainty evidence revealed no significant difference in mortality (OR = 0.91, 95% CI: 0.76-1.08) or LOHS (WMD = -0.24, 95% CI: -0.83 to 0.35) between FNC and Paxlovid in COVID-19 patients. Low-certainty evidence shows that the T-FNANC was longer (WMD = 1.95, 95% CI: 0.36-3.53). Compared with the Paxlovid group, low-certainty evidence shows the FNC group exhibited a worse composite outcome (OR = 0.77, 95% CI: 0.63-0.95) and fewer adverse events (OR = 0.63, 95% CI: 0.46-0.85). Compared with supportive treatment, low certainty shows FNC significantly reduced the mortality rate in COVID-19 patients (OR = 0.61, 95% CI: 0.51-0.74) and decreased the composite outcome (OR = 0.67, 95% CI: 0.50-0.91), and very low certainty evidence shows significantly decreased the T-FNANC (WMD = -4.62, 95% CI: -8.08 to -1.15). However, in very low certainty, there was no significant difference in LOHS (WMD = -0.70, 95% CI: -3.32 to 1.91) or adverse events (OR = 1.97, 95% CI: 0.48-8.17). Conclusions: FNC appears to be a safe and potentially effective treatment for COVID-19 in China, but further research with larger, high-quality studies is necessary to confirm these findings. Due to the certainty of the evidence and the specific context of the studies conducted in China, caution should be exercised when considering whether the results are applicable worldwide.
Author Contributions Study design: Wentao Zhang, Tao Dong, and Yuna Liu. Data collection: Wentao Zhang, Tingting Wu, Tao Dong, Yongxiang Ge, Qi Yang, and Jia Xu. Data analysis: Wentao Zhang and Tao Dong. Writing: Wentao Zhang, Tingting Wu, and Yuna Liu. All authors have reviewed the manuscript. Ethics Statement The authors have nothing to report. Conflicts of Interest The authors declare no conflicts of interest. Supporting Information Additional supporting information can be found online in the Supporting Information section.
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