Sofosbuvir/daclatasvir regimens for the treatment of COVID-19: an individual patient data meta-analysis.

Autor:	Simmons B; Department of Infectious Diseases, Imperial College London, London, UK., Wentzel H; School of Public Health, Imperial College London, London, UK., Mobarak S; Abadan Faculty of Medical Sciences, Abadan, Iran., Eslami G; Abadan Faculty of Medical Sciences, Abadan, Iran., Sadeghi A; Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran., Ali Asgari A; Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran., Abbaspour Kasgari H; Department of Clinical Pharmacy, School of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran., Tirgar Fakheri H; Gut and Liver Research Centre, Mazandaran University of Medical Sciences, Sari, Iran., Merat S; Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran., Hill A; Department of Translational Medicine, University of Liverpool, UK.
Jazyk:	angličtina
Zdroj:	The Journal of antimicrobial chemotherapy [J Antimicrob Chemother] 2021 Jan 19; Vol. 76 (2), pp. 286-291.
DOI:	10.1093/jac/dkaa418
Abstrakt:	Background: The combination of sofosbuvir and daclatasvir has a well-established safety profile and improves clinical outcomes in HCV patients. In silico and in vitro studies suggest that sofosbuvir/daclatasvir may show antiviral activity against SARS-CoV-2. Methods: Three clinical trials comparing sofosbuvir/daclatasvir-based regimens with a comparator in hospitalized COVID-19 patients were combined in a meta-analysis. The primary outcomes measured were clinical recovery within 14 days of randomization, time to clinical recovery and all-cause mortality. A two-step approach was used to analyse individual-level patient data. The individual trial statistics were pooled using the random-effects inverse-variance model. Results: Our search identified eight studies of which three met the inclusion criteria (n = 176 patients); two studies were randomized and one was non-randomized. Baseline characteristics were similar across treatment arms. Clinical recovery within 14 days of randomization was higher in the sofosbuvir/daclatasvir arms compared with control arms [risk ratio = 1.34 (95% CI = 1.05-1.71), P = 0.020]. Sofosbuvir/daclatasvir improves time to clinical recovery [HR = 2.04 (95% CI = 1.25-3.32), P = 0.004]. The pooled risk of all-cause mortality was significantly lower in the sofosbuvir/daclatasvir arms compared with control arms [risk ratio = 0.31 (95% CI = 0.12-0.78), P = 0.013]. Conclusions: Available evidence suggests that sofosbuvir/daclatasvir improves survival and clinical recovery in patients with moderate to severe COVID-19. However, the sample size for analysis was relatively small, one of the trials was not randomized and the designs were not standardized. These results need to be confirmed in larger randomized controlled trials. (© The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu