NEJM:瑞德西韦、羟氯喹、洛匹那韦和干扰素β-1a对新冠肺炎住院患者无明显治疗作用

2020-12-03 MedSci原创 MedSci原创

瑞德西韦、羟氯喹、洛匹那韦和干扰素β-1a在降低新冠肺炎患者死亡率、机械通气及住院时间方面均无显著效果

目前世界卫生组织专家组针对2019年冠状病毒病(Covid-19)住院患者开展了四种抗病毒药物的临床研究,包括瑞德西韦、羟氯喹、洛匹那韦和干扰素β-1a。近日研究人员对上述药物临床研究的结果进行了汇总,研究的主要终点为患者死亡率。
 
Covid-19住院患者参与研究,随机接受1种抗病毒药物方案或标准护理方案。意向治疗初步分析检查了每种试验药物及其对照对住院死亡率的影响,根据年龄和机械通气状况进行分层。
 
在30个国家的405家医院中,11330名成人新冠肺炎患者接受了随机分组:2750名接受瑞德西韦,954名接受羟氯喹治疗,1411名被分配到洛匹那韦(不含干扰素),2063名接受干扰素β-1a(包括651名联合洛匹那韦),4088名接受标准护理对照。治疗依从率为94%至96%,交叉治疗率2%至6%。总共报告了1253例死亡(中位死亡天数为第8天)。Kaplan-Meier 28天死亡率为11.8%(基线机械通气病人的死亡率为39.0%,未通气患者为9.5%)。2743例接受瑞德西韦治疗的患者中有301例死亡,2708例接受标准护理对照的患者中有303例死亡(比率比,0.95);947例接受羟氯喹治疗的患者中有104例死亡,对照组906例中84例死亡(比率1.19),1399例接受洛匹那韦治疗的患者中有148例死亡,对照组1372例中有146例死亡(比率比为1.00);2050例接受干扰素治疗的患者中有243例死亡,对照组2050例中有216例死亡(比率比为1.16)。没有一种药物能明显降低整体或任何亚组的死亡率、缩短通气或住院时间。
 
研究发现,瑞德西韦、羟氯喹、洛匹那韦和干扰素β-1a在降低新冠肺炎患者死亡率、机械通气及住院时间方面均无显著效果。
 
原始出处:
 
WHO Solidarity Trial Consortium. Repurposed Antiviral Drugs for Covid-19 - Interim WHO Solidarity Trial Results. N Engl J Med, December 2, 2020.

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  1. 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createdBy=f0620, createdName=公卫新人, createdTime=Thu Dec 03 22:04:28 CST 2020, time=2020-12-03, status=1, ipAttribution=)]
    2021-07-23 Fujian0319

    很优秀的研究

    0

  2. 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encryptionId=c8bd651103a, topicName=洛匹那韦)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a74e5737171, createdName=cathymary, createdTime=Sat Dec 05 10:04:28 CST 2020, time=2020-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1530130, encodeId=58081530130ab, content=<a href='/topic/show?id=171c48e20d5' target=_blank style='color:#2F92EE;'>#干扰素β#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48720, encryptionId=171c48e20d5, topicName=干扰素β)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c8bc12021096, createdName=huiwelcome, createdTime=Sat Dec 05 10:04:28 CST 2020, time=2020-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=905115, encodeId=8c4090511554, content=很重要的研究, beContent=null, objectType=article, channel=null, level=null, likeNumber=125, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200529/3611e9bb629c4e5b81fbd8ce784b06cc/128487eae357460bb98f67d86230c218.jpg, createdBy=ab235268530, createdName=神盾医疗局局长Jack, createdTime=Sat Dec 05 09:53:22 CST 2020, time=2020-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=904812, encodeId=7a9b90481250, content=<a href='/topic/show?id=bfa968e24a1' target=_blank style='color:#2F92EE;'>#瑞德西韦#</a>、羟氯喹、洛匹那韦和干扰素β-1a在降低新冠肺炎患者死亡率、机械通气及住院时间方面均无显著效果。 , beContent=null, objectType=article, channel=null, level=null, likeNumber=179, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68724, encryptionId=bfa968e24a1, topicName=瑞德西韦)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=仁心济世, createdTime=Fri Dec 04 11:50:50 CST 2020, time=2020-12-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=904689, encodeId=a3b1904689ed, content=收到<a href='/topic/show?id=23e3454e353' target=_blank style='color:#2F92EE;'>#学习#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45473, encryptionId=23e3454e353, topicName=学习)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201125/406f8efd94384014845836dbc1145ef8/2cd70ff60841419085fa1683b4048814.jpg, createdBy=465e2379549, createdName=张怀若, createdTime=Thu Dec 03 22:08:22 CST 2020, time=2020-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1028843, encodeId=f4c7102884324, content=新冠肺炎,疫情何时才能消失, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=公卫新人, createdTime=Thu Dec 03 22:04:28 CST 2020, time=2020-12-03, status=1, ipAttribution=)]
    2021-06-15 godlike6wei

    👍

    0

  4. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200529/3611e9bb629c4e5b81fbd8ce784b06cc/128487eae357460bb98f67d86230c218.jpg, createdBy=ab235268530, createdName=神盾医疗局局长Jack, createdTime=Sat Dec 05 09:53:22 CST 2020, time=2020-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=904812, encodeId=7a9b90481250, content=<a href='/topic/show?id=bfa968e24a1' target=_blank style='color:#2F92EE;'>#瑞德西韦#</a>、羟氯喹、洛匹那韦和干扰素β-1a在降低新冠肺炎患者死亡率、机械通气及住院时间方面均无显著效果。 , beContent=null, objectType=article, channel=null, level=null, likeNumber=179, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68724, encryptionId=bfa968e24a1, topicName=瑞德西韦)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=仁心济世, createdTime=Fri Dec 04 11:50:50 CST 2020, time=2020-12-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=904689, encodeId=a3b1904689ed, content=收到<a href='/topic/show?id=23e3454e353' target=_blank style='color:#2F92EE;'>#学习#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45473, encryptionId=23e3454e353, topicName=学习)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201125/406f8efd94384014845836dbc1145ef8/2cd70ff60841419085fa1683b4048814.jpg, createdBy=465e2379549, createdName=张怀若, createdTime=Thu Dec 03 22:08:22 CST 2020, time=2020-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1028843, encodeId=f4c7102884324, content=新冠肺炎,疫情何时才能消失, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=公卫新人, createdTime=Thu Dec 03 22:04:28 CST 2020, time=2020-12-03, status=1, ipAttribution=)]
    2020-12-05 lifefamily

    这是WHO大团结的试验的结果报道,#瑞德西韦##羟氯喹#、洛匹那韦和#干扰素#β-1a在降低#新冠肺炎#患者死亡率、机械通气及住院时间方面均无显著效果。美国FDA虽然批准了瑞德西韦在重症的作用,事实上那个作用可以忽略不计!再说,对于重症有效,几乎是不可以解释的。如果说早期应用,可能减少轻症向重症转换,这还是有可能的。

    1

    展开1条回复
  5. 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  6. 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  7. 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time=2020-12-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=904689, encodeId=a3b1904689ed, content=收到<a href='/topic/show?id=23e3454e353' target=_blank style='color:#2F92EE;'>#学习#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45473, encryptionId=23e3454e353, topicName=学习)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201125/406f8efd94384014845836dbc1145ef8/2cd70ff60841419085fa1683b4048814.jpg, createdBy=465e2379549, createdName=张怀若, createdTime=Thu Dec 03 22:08:22 CST 2020, time=2020-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1028843, encodeId=f4c7102884324, content=新冠肺炎,疫情何时才能消失, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, 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    2020-12-05 神盾医疗局局长Jack

    很重要的研究

    0

  8. 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time=2020-12-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=904689, encodeId=a3b1904689ed, content=收到<a href='/topic/show?id=23e3454e353' target=_blank style='color:#2F92EE;'>#学习#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45473, encryptionId=23e3454e353, topicName=学习)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201125/406f8efd94384014845836dbc1145ef8/2cd70ff60841419085fa1683b4048814.jpg, createdBy=465e2379549, createdName=张怀若, createdTime=Thu Dec 03 22:08:22 CST 2020, time=2020-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1028843, encodeId=f4c7102884324, content=新冠肺炎,疫情何时才能消失, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=公卫新人, createdTime=Thu Dec 03 22:04:28 CST 2020, time=2020-12-03, status=1, ipAttribution=)]
    2020-12-04 仁心济世

    #瑞德西韦#、羟氯喹、洛匹那韦和干扰素β-1a在降低新冠肺炎患者死亡率、机械通气及住院时间方面均无显著效果。

    0

  9. 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encryptionId=c8bd651103a, topicName=洛匹那韦)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a74e5737171, createdName=cathymary, createdTime=Sat Dec 05 10:04:28 CST 2020, time=2020-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1530130, encodeId=58081530130ab, content=<a href='/topic/show?id=171c48e20d5' target=_blank style='color:#2F92EE;'>#干扰素β#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48720, encryptionId=171c48e20d5, topicName=干扰素β)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c8bc12021096, createdName=huiwelcome, createdTime=Sat Dec 05 10:04:28 CST 2020, time=2020-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=905115, encodeId=8c4090511554, content=很重要的研究, beContent=null, objectType=article, channel=null, level=null, likeNumber=125, replyNumber=0, topicName=null, 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time=2020-12-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=904689, encodeId=a3b1904689ed, content=收到<a href='/topic/show?id=23e3454e353' target=_blank style='color:#2F92EE;'>#学习#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45473, encryptionId=23e3454e353, topicName=学习)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201125/406f8efd94384014845836dbc1145ef8/2cd70ff60841419085fa1683b4048814.jpg, createdBy=465e2379549, createdName=张怀若, createdTime=Thu Dec 03 22:08:22 CST 2020, time=2020-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1028843, encodeId=f4c7102884324, content=新冠肺炎,疫情何时才能消失, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=公卫新人, createdTime=Thu Dec 03 22:04:28 CST 2020, time=2020-12-03, status=1, ipAttribution=)]
    2020-12-03 张怀若

    收到#学习#

    0

  10. 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time=2020-12-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=904689, encodeId=a3b1904689ed, content=收到<a href='/topic/show?id=23e3454e353' target=_blank style='color:#2F92EE;'>#学习#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45473, encryptionId=23e3454e353, topicName=学习)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201125/406f8efd94384014845836dbc1145ef8/2cd70ff60841419085fa1683b4048814.jpg, createdBy=465e2379549, createdName=张怀若, createdTime=Thu Dec 03 22:08:22 CST 2020, time=2020-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1028843, encodeId=f4c7102884324, content=新冠肺炎,疫情何时才能消失, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=公卫新人, createdTime=Thu Dec 03 22:04:28 CST 2020, time=2020-12-03, status=1, ipAttribution=)]
    2020-12-03 公卫新人

    新冠肺炎,疫情何时才能消失

    0

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