Advances in the effectiveness and safety of azvudine treatment: a comprehensive review
Jiayi Li, Bo Zhu, Jian Lu, Zheyi Dong, Ping Li, Wenge Li, Chunfu Zheng, Junbiao Chang, Shunlai Shang
Frontiers in Pharmacology, doi:10.3389/fphar.2025.1524072
The global impact of COVID-19 has highlighted the urgent need for effective therapeutic interventions against SARS-CoV-2. Azvudine, a dual-target nucleoside drug initially developed for human immunodeficiency virus (HIV), has gained attention for its potential in treating COVID-19. On 25 July 2022, Azvudine received conditional approval from the National Medical Products Administration (NMPA) of China, making it the first oral SARS-CoV-2 RNAdependent RNA polymerase (RdRp) inhibitor for COVID-19 treatment. This review explores the pharmacological activity, antiviral mechanisms, and clinical effectiveness of azvudine in the context of COVID-19. Clinical trials have demonstrated its ability to reduce the viral load, shorten the time to nucleic acid negativity, and improve clinical outcomes in patients. Additionally, azvudine has shown excellent pharmacokinetic properties and a favorable safety profile with mild side effects. The review also addresses the importance of drug interactions and safety considerations, particularly in high-risk populations. Research should focus on optimizing second-generation inhibitors with enhanced effectiveness against SARS-CoV-2 variants, improving oral bioavailability, and minimizing adverse effects, ensuring more robust treatment options for COVID-19.
Author contributions JyL: Writingoriginal draft, Writingreview and editing. BZ: Conceptualization, Writingreview and editing, Data curation. JnL: Writingreview and editing. ZD: Conceptualization, Methodology, Supervision, Writingreview and editing. PL: Methodology, Project administration, Writingreview and editing. WL: Conceptualization, Supervision, Writingoriginal draft. CZ: Supervision, Validation, Writingreview and editing. JC: Writingreview and editing, Investigation. SS: Writingreview and editing, Conceptualization, Supervision, Writingoriginal draft.
Conflict of interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Generative AI statement The author(s) declare that no Gen AI was used in the creation of this manuscript.
Publisher's note All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.
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