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瑞德西韦:从埃博拉病毒病到 COVID-19 的希望之光。

Remdesivir: A beacon of hope from Ebola virus disease to COVID-19.

机构信息

Department of Dermatology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Rev Med Virol. 2020 Nov;30(6):1-13. doi: 10.1002/rmv.2133. Epub 2020 Jul 30.

Abstract

Since the emergence of coronavirus disease 2019 (Covid-19), many studies have been performed to characterize severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and find the optimum way to combat this virus. After suggestions and assessments of several therapeutic options, remdesivir (GS-5734), a direct-acting antiviral drug previously tested against Ebola virus disease, was found to be moderately effective and probably safe for inhibiting SARS-CoV-2 replication. Finally, on 1 May 2020, remdesivir (GS-5734) was granted emergency use authorization as an investigational drug for the treatment of Covid-19 by the Food and Drug Administration. However, without a doubt, there are challenging days ahead. Here, we provide a review of the latest findings (based on preprints, post-prints, and news releases in scientific websites) related to remdesivir efficacy and safety for the treatment of Covid-19, along with covering remdesivir history from bench-to-bedside, as well as an overview of its mechanism of action. In addition, active clinical trials, as well as challenging issues related to the future of remdesivir in Covid-19, are covered. Up to the date of writing this review (19 May 2020), there is one finished randomized clinical trial and two completed non-randomized studies, in addition to some ongoing studies, including three observational studies, two expanded access studies, and seven active clinical trials registered on the clinicaltrials.gov and isrctn.com websites. Based on these studies, it seems that remdesivir could be an effective and probably safe treatment option for Covid-19. However, more randomized controlled studies are required.

摘要

自 2019 年冠状病毒病(COVID-19)出现以来,已经进行了许多研究来描述严重急性呼吸综合征冠状病毒 2(SARS-CoV-2),并寻找对抗这种病毒的最佳方法。在对几种治疗选择提出建议并进行评估后,发现先前针对埃博拉病毒病进行过测试的直接作用抗病毒药物瑞德西韦(GS-5734)在抑制 SARS-CoV-2 复制方面具有中等疗效且可能安全。最终,2020 年 5 月 1 日,食品和药物管理局(FDA)批准瑞德西韦(GS-5734)作为治疗 COVID-19 的研究性药物紧急使用授权。然而,毫无疑问,未来仍将面临挑战。在这里,我们根据科学网站上的预印本、后印本和新闻稿提供了有关瑞德西韦治疗 COVID-19 的疗效和安全性的最新发现的综述,涵盖了瑞德西韦从实验室到病床的历史,以及对其作用机制的概述。此外,还涵盖了正在进行的临床试验以及与瑞德西韦在 COVID-19 中的未来相关的具有挑战性的问题。截至撰写本综述之日(2020 年 5 月 19 日),除了一些正在进行的研究外,还有一项已完成的随机临床试验和两项已完成的非随机研究,其中包括三项观察性研究、两项扩展获得研究和七项在 clinicaltrials.gov 和 isrctn.com 网站上注册的活跃临床试验。根据这些研究,瑞德西韦似乎是一种有效的且可能安全的 COVID-19 治疗选择。然而,还需要更多的随机对照研究。

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