RETHINKING: IS FAVIPIRAVIR EFFECTIVE FOR ACHIEVING FASTER TIME TO VIRAL CLEARANCE IN MODERATE HOSPITALIZED COVID-19 PATIENTS?

Main Article Content

Ayers Gilberth Ivano Kalaij
Berly Shandika
Dimas Arif Nugroho
Elena Firnandy Meisha
Laratasya Bamba Lati
Melva Louisa

Keywords

antiviral, favipiravir, SARS-COV2, therapy, viral clearance

Abstract

Background and Aim:


Despite favipiravir being a recommended antiviral for patients with mild symptoms of COVID-19, there is still debate about whether it can be used for patients with moderate severity. Therefore, the current review was aimed to determine the efficacy of favipiravir in achieving viral clearance compared to standard care in hospitalized moderate COVID-19 patients.


Methods:


We conducted a literature search in studies investigating the efficacy of favipiravir vs. standard care in hospitalized patients with moderate to severe COVID-19 in the time to achieve viral clearance. Eligible studies were included and appraised in their validity, importance, and applicability. Furthermore, included studies were ranked according to their level of evidence (LOE)


Results:


Five studies were included and assessed further. All studies showed the superiority of favipiravir administration which has successfully lowered the time to viral clearance up to 95% compared to standard care and achieved a higher viral clearance rate at a certain period (day five and day 10). However, some studies have shown insignificant results. Despite that, further studies are still needed to confirm these findings.


Conclusion:


In moderate hospitalized COVID-19 patients, favipiravir can potentially accelerate viral clearance rate or time to viral clearance by up to 95% compared to standard of care. Favipiravir can be an option with fewer side effects than other available antivirals and can be suggested for COVID-19 patients with moderate symptoms.


 

Abstract 201 | Pdf Downloads 112

References

1. World Health Organization. Coronavirus (COVID-19) Dashboard. Available from: https://www.worldometers.info/coronavirus/ https://covid19.who.int
2. World Health Organization. Therapeutics and COVID-19: Living Guideline. 22 APRIL 2022. Geneva: World Health Organization; 2022 (WHO/2019-nCoV/therapeutics/2022.3).
3. Joshi S, Vora A, Venugopal K, Dadhich P, Daxini A, Bhagat S, Patil S, Barkate H. Real-World Experience with Favipiravir for the Treatment of Mild-to-Moderate COVID-19 in India. Pragmat Obs Res. 2022; 13: 33-41
4. Shinkai M, Tsushima K, Tanaka S, et al. Efficacy and Safety of Favipiravir in Moderate COVID-19 Pneumonia Patients without Oxygen Therapy: A Randomized, Phase III Clinical Trial. Infect Dis Ther. 2021;10(4):2489-2509. doi:10.1007/s40121-021-00517-4
5. Mohammad Bosaeed, Ahmad Alharbi, Ebrahim Mahmoud, Sanaa Alrehily, Mohannad Bahlaq, Zied Gaifer, et al. Efficacy of favipiravir in adults with mild COVID-19: a randomized, double-blind, multicentre, placebo-controlled clinical trial, Clinical Microbiology and Infection, Volume 28, Issue 4, 2022, Pages 602-608, ISSN 1198-743X, https://doi.org/10.1016/j.cmi.2021.12.026.
6. Hassanipour S, Arab-Zozani M, Amani B, Heidarzad F, Fathalipour M, Martinez-de-Hoyo R. The efficacy and safety of Favipiravir in treatment of COVID-19: a systematic review and meta-analysis of clinical trials. Sci Rep. 2021 May 26;11(1):11022. doi: 10.1038/s41598-021-90551-6.
7. Manabe T, Kambayashi D, Akatsu H, Kudo K. Favipiravir for the treatment of patients with COVID-19: a systematic review and meta-analysis. BMC Infect Dis. 2021 May 27;21(1):489.
8. Chang D, Mo G, Yuan X, Tao Y, Peng X, Wang FS, Xie L, Sharma L, Dela Cruz CS, Qin E. Time kinetics of viral clearance and resolution of symptoms in novel coronavirus infection. Am J Respir Crit Care Med. 2020 May 1;201(9):1150-1152
9. Samrah SM, Al-Mistarehi AH, Kewan T, Al-Khatib SM, Ibnian AM, Samrah RS, Khassawneh BY. Viral Clearance Course of COVID-19 Outbreaks. J Multidiscip Healthc. 2021 Mar 4; 14:555-565.
10. Focosi D, Franchini M, Pirofski LA, Maggi F, Casadevall A. Is SARS-CoV-2 viral clearance in nasopharyngeal swabs an appropriate surrogate marker for clinical efficacy of neutralising antibody-based therapeutics? Rev Med Virol. 2021 Dec 3:e2314.
11. Centre for Evidence-Based Medicine. Critical Appraisal Tools. University of Oxford. Available from: https://www.cebm.ox.ac.uk/resources/ebm-tools/critical-appraisal-tools.
12. Ivashchenko, A.A., Dmitriev, K.A., Vostokova, N.V., Azarova, V.N., Blinow, A.A., Egorova, A.N., Gordeev, I.G., Ilin, A.P., Karapetian, R.N., Kravchenko, D.V. and Lomakin, N.V., 2021. FAVIFAVIR for treatment of patients with moderate coronavirus disease 2019 (COVID-19): interim results of a phase II/III multicenter randomized clinical trial. Clinical Infectious Diseases, 73(3), pp.531-4.
13. Finberg RW, Ashraf M, Julg B, Ayoade F, Marathe JG, Issa NC, Wang JP, Jaijakul S, Baden LR, Epstein C. US201 Study: A Phase 2, Randomized Proof-of-Concept Trial of Favipiravir for the Treatment of COVID-19. InOpen forum infectious diseases 2021 Dec (Vol. 8, No. 12, p. ofab563). US: Oxford University Press.
14. Udwadia ZF, Singh P, Barkate H, Patil S, Rangwala S, Pendse A, Kadam J, Wu W, Caracta CF, Tandon M. Efficacy and safety of favipiravir, an oral RNA-dependent RNA polymerase inhibitor, in mild-to-moderate COVID-19: A randomized, comparative, open-label, multicenter, phase 3 clinical trial. Int J Infect Dis. 2021 Feb; 103:62-71.
15. Promomed LLC. Open-label Randomized Multicenter Comparative Study on the Efficacy and Safety of Areplivir Film-coated Tablets (PROMOMED RUS LLC, Russia) in Patients Hospitalized With COVID-19. In: ClinicalTrials.gov [Internet]. Bethesda (MD): National Library of Medicine (US). 2020- [cited 2022 Mar 20]. Available from: https://clinicaltrials.gov/ct2/show/study/NCT04542694 of the record NLM Identifier: NCT04542694.
16. Ruzhentsova TA, Oseshnyuk RA, Soluyanova TN, Dmitrikova EP, Mustafaev DM, Pokrovskiy KA, et al. Phase 3 trial of Coronavir (favipiravir) in patients with mild to moderate COVID-19. Am J Transl Res. 2021 Nov 15;13(11):12575-87.