Leczenie eksperymentalne COVID-19

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Leczenie eksperymentalne COVID-19 – strategie terapeutyczne mające na celu znalezienie leków skutecznych w zwalczaniu choroby COVID-19.

Do końca maja 2020 nie zostały opracowane lekarstwa ani szczepionki leczące lub zapobiegające zakażeniu SARS-CoV-2. W związku z pandemią COVID-19 w 2020 r. w wielu ośrodkach na świecie rozpoczęto intensywne poszukiwania leków mających zastosowanie w leczeniu COVID-19[1]. Do analizowanych terapii zaliczają się procedury z wykorzystaniem leków przeciwwirusowych, przeciwciał monoklonalnych, peptydów, oligonukleotydów, interferonów, a także szczepionki. W celu jak najszybszego wprowadzenia leków na COVID-19 badane są możliwości wykorzystania istniejących leków mających dotychczas inne zastosowania. Można do nich zaliczyć m.in. leki przeciw wirusom HIV, HBV, HCV, grypy oraz inne, oparte na doświadczeniu w leczeniu infekcji wywołanych przez koronawirusy, takich jak SARS i MERS[1][2][3]. Większość badań klinicznych (wieloośrodkowe adaptacyjne RCT[4]) dotyczących leczenia COVID-19 zostało uruchomionych w Chinach[5]. Największą grupę potencjalnych leków stanowią środki wykorzystywane w tradycyjnej medycynie chińskiej (32%), czasem w kombinacji z tradycyjną medycyną zachodnią (15%). Ponadto badane są znane leki przeciwwirusowe (23%), bioterapeutyki (interferony, komórki macierzyste, immunoterapeutyki i in.) (15%) i leki przeciwmalaryczne (10%), a także, a mniejszym stopniu glikokortykoidy (3%), i osocze (2%)[5].

Lista leków eksperymentalnych stosowanych w leczeniu COVID-19
Lek Lokalizacja badania
Remdesiwir Hubei, Chiny[6]

Pekin, Chiny[7]

międzynarodowe[8]

inne[9][10]

Hiszpania[11][12]

Lopinawir + rytonawir Wuhan, Chiny[13][6][14]

Guangdong, Chiny[7][15]

Hongkong[9]

Uniwersytet Zhejiang, Chiny[10]

Jiangxi, Chiny[16][17]

Chongqing, Chiny[18][19]

Hubei, Chiny[20][21]

różne miasta[22][23]

Syczuan, Chiny[24]

Zhejiang, Chiny[25]

Zhuhai, Chiny[26]

Lopinawir Zhejiang, Chiny[27]
ASC09 + rytonawir Uniwersytet Zhejiang, Chiny[10]; Chongqing, Chiny[19]
Danoprewir + rytonawir Jiangxi, Chiny[16]
Fawipirawir Zhejiang, Chiny[25]

Guangdong, Chiny[28][29]

Pekin, Chiny[30]

Wuhan, Chiny[31]

Fawipirawir + bromoheksyna Zhejiang, Chiny[32]
Rybawiryna Hong kong[9]Chongqing, Chiny[18]
Umifenowir Chongqing, Chiny[19]

różne miasta, Chiny[22]

Tongji, Chiny[33]

Szanghaj, Chiny[34]

Zhejiang, Chiny[27]

Szanghaj, Chiny[35][36]

Hubei, Chiny[37][38]

Ruijin, Chiny[39]

Komórki macierzyste Hubei, Chiny[40][41][42][43][44][45][46][47]

Pekin, Chiny[48]

Zhejiang, Chiny[49]

Chiny[50][51][52]

Guangdong, Chiny[53][54][55][56]

Pekin, Hubei, Szanghaj, Chiny[57]

Pekin, Chiny[58]

Jiangxi, Chiny[59]

nieznana[60]

Darunawir + kobicystat Szanghaj, Chiny[61]

Hubei, Chiny[62]

Azwudyna Henan, Chiny[63][64][65]
Triazawiryna Heilongjiang, Chiny[66]
Emtrycytabina Syczuan, Chiny[24]
Marboksyl baloksawiru Zhejiang, Chiny[25]

Guangdong, Chiny[28]

Alafenamid tenofowiru Syczuan, Chiny[24]
Nowaferon Jiangxi, Chiny[16]Zhejiang, Chiny[27]
Peginterferon alfa-2a Jiangxi, Chiny[16]
Interferon beta-1b Hong kong[9]
Interferon alfa-1b Chongqing, Chiny[18]Tongji, Chiny[67]

Hubei, Chiny[68]

Interferon Syczuan, Chiny[69]

Hunan, Chiny[70]

Szanghaj, Chiny[71]

Tradycyjne leki chińskie Jiangxi, Chiny[16]
Chlorochina różne miasta, Chiny[22]

Szanghaj, Chiny[72] Guangdong, Chiny[73][15][74]

Hubei, Chiny[75]

Zhunghai, Chiny[26]

Hubei, Chiny[76][77][78]

Chongqing, Chiny[79][80]różne miasta, Chiny[81][82][83]

Jilin, Chiny[84]

Heilongjiang, China[85]

Hydroksychlorochina różne miasta, Chiny[81][82][83]

Hubei, Chiny[78][38]

Francja[86]

Karrimycyna różne miasta, Chiny[22][87]
Oseltamiwir Tongji, Chiny[88]
Przeciwciała Chiny[89]
Immunoglobuliny Tongji, Chiny[90]

Hubei, Chiny[91]

Metyloprednizolon Pekin, Chiny[92]

Tongji, Chiny[93]

Hubei, Chiny[94][95]

Chongqing, Chiny[96]

Dezaktywowane osocze przeciw wirusowi SARS-CoV-2 Hubei, Chiny[97][98][99][100]
Osocze pobrane od rekonwalescentów Zhejiang, Chiny[101]

Jiangsu, Chiny[102]

Meplazumab Shaanxi, Chiny[103]
Bewacyzumab Shandong, Chiny[104]
Ekulizumab USA[105]
Tocilizumab Anhui, Chiny[106]

Shaanxi, Chiny[107]

Adalimumab Szanghaj, Chiny[108]
vMIP Hubei, China[109]
Komórki NK Henan, Chiny[110]
Cytokiny Shaanxi, Chiny[111]
Makrofagi Chiny[112]
Tymozyna Chiny[89][113]
Fingolimod Fuzhou, Chiny[114]
Pirfenidon Hubei, Chiny[115][116]
Kwas poliinozyno-policytydylowy (pIC) Zheijang, Chiny[117]
Leflunomid Hubei, Chiny[118]
Dihydroartemizynina/piperachin Jiangxi, Chiny[119]
Tlenek azotu Chiny[120][121]
Ciągłe pozaustrojowe natlenianie krwi Chiny[122]
Talidomid Chiny[123][124]
Dipirydamol Chiny[125]
Acetylocysteina Hubei, Chiny[126]
Zasadowy cytrynian bizmutawy Wuhan, Chiny[127]

Zobacz też[edytuj | edytuj kod]

Przypisy[edytuj | edytuj kod]

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  84. Single arm study for exploration of chloroquine phosphate aerosol inhalation in the treatment of novel coronavirus pneumonia (COVID-19), www.chictr.org.cn, ChiCTR2000029975 [dostęp 2020-03-15].
  85. Efficacy and safety of chloroquine phosphate inhalation combined with standard therapy in the treatment of novel coronavirus pneumonia (COVID-19), www.chictr.org.cn, ChiCTR2000030417 [dostęp 2020-03-15].
  86. Treatment of Coronavirus SARS-Cov2 Respiratory Infections with Hydroxychloroquine. Clinical trials for eudract_number:2020-000890-25. www.clinicaltrialsregister.eu, dostęp 15.03.2020
  87. The efficacy and safety of carrimycin treatment in patients with novel coronavirus pneumonia (COVID-19): a multicenter, randomized, open-label, controlled trial, www.chictr.org.cn [dostęp 2020-03-14].
  88. A Randomized,Open,Controlled Clinical Study to Evaluate the Efficacy of ASC09F and Ritonavir for 2019-nCoV Pneumonia, [w:] ClinicalTrials.gov [online], National Institutes of Health, NCT04261270 [dostęp 2020-03-14] (ang.).
  89. a b Immunoregulatory Therapy for 2019-nCoV, [w:] ClinicalTrials.gov [online], National Institutes of Health, NCT04268537 [dostęp 2020-03-15] (ang.).
  90. The Efficacy of Intravenous Immunoglobulin Therapy for Severe 2019-nCoV Infected Pneumonia, [w:] ClinicalTrials.gov [online], National Institutes of Health, NCT04261426 [dostęp 2020-03-15] (ang.).
  91. Treatment of Acute Severe 2019-nCoV Pneumonia With Immunoglobulin From Cured Patients, [w:] ClinicalTrials.gov [online], National Institutes of Health, NCT04264858 [dostęp 2020-03-15] (ang.).
  92. Glucocorticoid Therapy for Novel Coronavirus Critically Ill Patients With Severe Acute Respiratory Failure, [w:] ClinicalTrials.gov [online], National Institutes of Health, NCT04244591 [dostęp 2020-03-15] (ang.).
  93. The Efficacy of Different Hormone Doses in 2019-nCoV Severe Pneumonia, [w:] ClinicalTrials.gov [online], National Institutes of Health, NCT04263402 [dostęp 2020-03-15] (ang.).
  94. Efficacy and Safety of Corticosteroids in COVID-19, [w:] ClinicalTrials.gov [online], National Institutes of Health, NCT04273321 [dostęp 2020-03-15] (ang.).
  95. A randomized, open-label study to evaluate the efficacy and safety of low-dose corticosteroids in hospitalized patients with novel coronavirus pneumonia (COVID-19), www.chictr.org.cn, ChiCTR2000029656 [dostęp 2020-03-15].
  96. Effectiveness of glucocorticoid therapy in patients with severe novel coronavirus pneumonia: protocol of a randomized controlled trial, www.unboundmedicine.com, ChiCTR2000029386 [dostęp 2020-03-15] (ang.).
  97. A randomized, double-blind, parallel-controlled, trial to evaluate the efficacy and safety of anti-SARS-CoV-2 virus inactivated plasma in the treatment of severe novel coronavirus pneumonia patients (COVID-19), www.chictr.org.cn, ChiCTR2000030010 [dostęp 2020-03-15].
  98. A single arm trial to evaluate the efficacy and safety of anti-2019-nCoV inactivated convalescent plasma in the treatment of novel coronavirus pneumonia patient (COVID-19), www.chictr.org.cn, ChiCTR2000030046 [dostęp 2020-03-15].
  99. Cancelled by investigator A randomized, open-label, controlled and single-center trial to evaluate the efficacy and safety of anti-SARS-CoV-2 inactivated convalescent plasma in the treatment of novel coronavirus pneumonia (COVID-19) patient, www.chictr.org.cn, ChiCTR2000030381 [dostęp 2020-03-15].
  100. Cancelled, due to modify the protocol A single-center, open-label and single arm trial to evaluate the efficacy and safety of anti-SARS-CoV-2 inactivated convalescent plasma in the treatment, www.chictr.org.cn, ChiCTR2000030312 [dostęp 2020-03-15].
  101. Study on convalescent plasma treatment for severe patients with novel coronavirus pneumonia (COVID-19), www.chictr.org.cn, ChiCTR2000029850 [dostęp 2020-03-15].
  102. Clinical study for infusing convalescent plasma to treat patients with new coronavirus pneumonia (COVID-19), www.chictr.org.cn, ChiCTR2000030039 [dostęp 2020-03-15].
  103. Clinical Study of Anti-CD147 Humanized Meplazumab for Injection to Treat With 2019-nCoV Pneumonia, [w:] ClinicalTrials.gov [online], National Institutes of Health, NCT04275245 [dostęp 2020-03-15] (ang.).
  104. Bevacizumab in Severe or Critical Patients With COVID-19 Pneumonia, [w:] ClinicalTrials.gov [online], National Institutes of Health, NCT04275414 [dostęp 2020-03-15] (ang.).
  105. Eculizumab (Soliris) in Covid-19 Infected Patients, [w:] ClinicalTrials.gov [online], National Institutes of Health, NCT04288713 [dostęp 2020-03-15] (ang.).
  106. A multicenter, randomized controlled trial for the efficacy and safety of tocilizumab in the treatment of new coronavirus pneumonia (COVID-19), www.chictr.org.cn, ChiCTR2000029765 [dostęp 2020-03-15].
  107. Cancelled by the investigator Combination of Tocilizumab, IVIG and CRRT in severe patients with novel coronavirus pneumonia (COVID-19), www.chictr.org.cn, ChiCTR2000030442 [dostęp 2020-03-15].
  108. A clinical study for the efficacy and safety of Adalimumab Injection in the treatment of patients with severe novel coronavirus pneumonia (COVID-19), www.chictr.org.cn, ChiCTR2000030089 [dostęp 2020-03-15].
  109. Efficacy and safety of aerosol inhalation of vMIP in the treatment of novel coronavirus pneumonia (COVID-19): a single arm clinical trial, www.chictr.org.cn, ChiCTR2000029636 [dostęp 2020-03-15].
  110. NK Cells Treatment for Novel Coronavirus Pneumonia, [w:] ClinicalTrials.gov [online], National Institutes of Health, NCT04280224 [dostęp 2020-03-15] (ang.).
  111. Cancelled by the investigator Clinical trial for umbilical cord blood CIK and NK cells in the treatment of mild and general patients infected with novel coronavirus pneumonia (COVID-19), www.chictr.org.cn, ChiCTR2000030329 [dostęp 2020-03-15].
  112. Clinical study for the remedy of M1 macrophages target in the treatment of novel coronavirus pneumonia (COVID-19), www.chictr.org.cn, ChiCTR2000029431 [dostęp 2020-03-15].
  113. Immunomodulatory Therapy for Severe Novel Coronavirus Pneumonia (COVID-19), www.chictr.org.cn, ChiCTR2000029806 [dostęp 2020-03-15].
  114. Fingolimod in COVID-19, [w:] ClinicalTrials.gov [online], National Institutes of Health, NCT04280588 [dostęp 2020-03-15] (ang.).
  115. A Study to Evaluate the Efficacy and Safety of Pirfenidone With Novel Coronavirus Infection, [w:] ClinicalTrials.gov [online], National Institutes of Health, NCT04282902 [dostęp 2020-03-15] (ang.).
  116. A Study to Evaluate the Efficacy and Safety of Pirfenidone With Novel Coronavirus Infection, [w:] ClinicalTrials.gov [online], National Institutes of Health, NCT04282902 [dostęp 2020-03-15] (ang.).
  117. A randomized, open-label, blank-controlled, multicenter trial for Polyinosinic-Polycytidylic Acid Injection in the treatment of novel coronavirus pneumonia (COVID-19), www.chictr.org.cn, ChiCTR2000029776 [dostęp 2020-03-15].
  118. A multicenter, randomized, double-blind, controlled clinical trial for leflunomide in the treatment of novel coronavirus pneumonia (COVID-19), www.chictr.org.cn, ChiCTR2000030058 [dostęp 2020-03-15].
  119. Cancelled by the investigator Randomized controlled trial for the efficacy of dihydroartemisinine piperaquine in the treatment of mild/common novel coronavirus pneumonia (COVID-19), www.chictr.org.cn, ChiCTR2000030082 [dostęp 2020-03-15].
  120. Nitric Oxide Gas Inhalation Therapy for Mild/Moderate COVID19 Infection, [w:] ClinicalTrials.gov [online], National Institutes of Health, NCT04290858 [dostęp 2020-03-15] (ang.).
  121. Nitric Oxide Gas Inhalation for Severe Acute Respiratory Syndrome in COVID-19, [w:] ClinicalTrials.gov [online], National Institutes of Health, NCT04290871 [dostęp 2020-03-15] (ang.).
  122. Clinical Application of ECMO in the Treatment of Patients with Very Serious Respiratory Failure due to novel Coronavirus Pneumonia (COVID-19), www.chictr.org.cn, ChiCTR2000029804 [dostęp 2020-03-15].
  123. The Efficacy and Safety of Thalidomide Combined With Low-dose Hormones in the Treatment of Severe COVID-19, [w:] ClinicalTrials.gov [online], National Institutes of Health, NCT04273581 [dostęp 2020-03-15] (ang.).
  124. The Efficacy and Safety of Thalidomide in the Adjuvant Treatment of Moderate New Coronavirus (COVID-19) Pneumonia, [w:] ClinicalTrials.gov [online], National Institutes of Health, NCT04273529 [dostęp 2020-03-15] (ang.).
  125. Multicenter study for the treatment of Dipyridamole with novel coronavirus pneumonia (COVID-19), www.chictr.org.cn, ChiCTR2000030055 [dostęp 2020-03-15].
  126. Clinical application of inhaled acetylcysteine solution in the treatment of novel coronavirus pneumonia (COVID-19), www.chictr.org.cn, ChiCTR2000030328 [dostęp 2020-03-15].
  127. A randomized, double-blind, placebo-controlled trial for evaluation of the efficacy and safety of bismuth potassium citrate capsules in the treatment of patients with novel coronavirus pneumonia (COVID-19), www.chictr.org.cn, ChiCTR2000030398 [dostęp 2020-03-15].

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