Perbandingan Luaran Klinis Favipiravir dan Remdesivir pada Pasien Covid-19 Derajat Sedang di RS Akademik UGM Yogyakarta

https://doi.org/10.22146/jmpf.84815

Hadiatussalamah Hadiatussalamah(1), Tri Murti Andayani(2*), Ika Puspita Sari(3)

(1) Magister Farmasi Klinik, Fakultas Farmasi, Universitas Gadjah Mada
(2) Departemen Farmakologi dan Farmasi Klinik, Fakultas Farmasi, Universitas Gadjah Mada
(3) Departemen Farmakologi dan Farmasi Klinik, Fakultas Farmasi, Universitas Gadjah Mada
(*) Corresponding Author

Abstract


Research on effective antivirals for COVID-19 is still ongoing. Favipiravir and remdesivir are antivirals that have been recommended in Indonesia. This study aimed to compare the clinical outcomes of favipiravir and remdesivir in moderate COVID-19 patients. This research is a retrospective cohort study conducted at the UGM Academic Hospital Yogyakarta using electronic medical records of moderate COVID-19 who were hospitalized from June 2021 to March 2022. Each therapy group consisted of 88 subjects. Clinical outcomes in the form of improved and not-improved conditions were assessed using a 7-point ordinal scale of progressivity and recovery of COVID-19 from WHO. Chi-square analysis and multiple logistic regression were performed to determine the relationship between the research variables. The highest percentage of research subjects were aged 18 – 59 years (70,5%), male (53,4%), and not obese (64,2%). The most common comorbidities were diabetes mellitus (33%) and hypertension (30%). The favipiravir group had a better clinical outcome than remdesivir. The proportion of patients improving in the favipiravir group was 50,0% and 35,3% in the remdesivir group (p-value=0,048). There was no significant difference in the number of adverse events between both study groups (p-value > 0,05). The most common adverse drug events were nausea (35,2%), vomiting (14,2%), and heartburn (11,4%).  


Keywords


COVID-19; antiviral; luaran klinis; favipiravir; remdesivir

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References

  1. WHO Coronavirus (COVID-19) Dashboard. Accessed March 3, 2023. https://covid19.who.int
  2. Vegivinti CTR, Evanson KW, Lyons H, et al. Efficacy of antiviral therapies for COVID-19: a systematic review of randomized controlled trials. BMC Infect Dis. 2022;22:107. doi:10.1186/s12879-022-07068-0
  3. Angamo MT, Mohammed MA, Peterson GM. Efficacy and safety of remdesivir in hospitalised COVID-19 patients: a systematic review and meta-analysis. Infection. 2022;50(1):27-41. doi:10.1007/s15010-021-01671-0
  4. Burhan E, Susanto AD, Nasution SA, et al. Perhimpunan Dokter Paru Indonesia (PDPI) Perhimpunan Dokter Spesialis Kardiovaskular Indonesia (PERKI) Perhimpunan Dokter Spesialis Penyakit Dalam Indonesia (PAPDI) Perhimpunan Dokter Anestesiologi dan Terapi Intensif Indonesia. Published online 2022:176.
  5. Damayanti H, Sajinadiyasa IGK, Risni HW, Sauriasari R. The Effectiveness and Safety of Favipiravir in COVID-19 Hospitalized Patients at Tertiary Referral Hospital, Bali, Indonesia. Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal). 2021;16(4). doi:10.21109/kesmas.v16i4.5433
  6. Satriyani N, Rahmawati F, Andayani TM. Perbandingan Angka Kematian Terapi Antiviral Favipiravir dan Remdesivir pada Pasien COVID-19 Di RSUP Dr. Sardjito Yogyakarta. JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice). 2023;12(4):223-233. doi:10.22146/jmpf.77288
  7. Lemeshow S, World Health Organization, eds. Adequacy of Sample Size in Health Studies. Published on behalf of the World Health Organization by Wiley ; Distributed in the U.S.A., Canada, and Japan by Liss; 1990.
  8. Priya S, Selva Meena M, Sangumani J, Rathinam P, Brinda Priyadharshini C, Vijay Anand V. “Factors influencing the outcome of COVID-19 patients admitted in a tertiary care hospital, Madurai.- a cross-sectional study.” Clin Epidemiol Glob Health. 2021;10:100705. doi:10.1016/j.cegh.2021.100705
  9. CDC. Cases, Data, and Surveillance. Centers for Disease Control and Prevention. Published February 11, 2020. Accessed April 2, 2023. https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-death-by-age.html
  10. Wang D, Hu B, Hu C, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-1069. doi:10.1001/jama.2020.1585
  11. Grasselli G, Zangrillo A, Zanella A, et al. Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, Italy. JAMA. 2020;323(16):1574-1581. doi:10.1001/jama.2020.5394
  12. Pradhan A, Olsson PE. Sex differences in severity and mortality from COVID-19: are males more vulnerable? Biol Sex Differ. 2020;11:53. doi:10.1186/s13293-020-00330-7
  13. Goldman JD, Lye DCB, Hui DS, et al. Remdesivir for 5 or 10 Days in Patients with Severe Covid-19. N Engl J Med. 2020;383(19):1827-1837. doi:10.1056/NEJMoa2015301
  14. Udwadia ZF, Singh P, Barkate H, et al. 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;103:62-71. doi:10.1016/j.ijid.2020.11.142
  15. 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
  16. WHO Solidarity Trial Consortium. Repurposed Antiviral Drugs for Covid-19 — Interim WHO Solidarity Trial Results. N Engl J Med. 2021;384(6):497-511. doi:10.1056/NEJMoa2023184
  17. Wang Y, Zhang D, Du G, et al. Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial. Lancet. 2020;395(10236):1569-1578. doi:10.1016/S0140-6736(20)31022-9
  18. Barratt-Due A, Olsen IC, Nezvalova-Henriksen K, et al. Evaluation of the Effects of Remdesivir and Hydroxychloroquine on Viral Clearance in COVID-19. Ann Intern Med. Published online July 13, 2021:M21-0653. doi:10.7326/M21-0653
  19. Mahajan L, Singh AP, Gifty. Clinical outcomes of using remdesivir in patients with moderate to severe COVID-19: A prospective randomised study. Indian J Anaesth. 2021;65(Suppl 1):S41-S46. doi:10.4103/ija.IJA_149_21
  20. Dahlan MS. Analisis Multivariat Regresi Logistik. 2nd ed. PT Epidemiologi Indonesia; 2012.
  21. Zaki N, Alashwal H, Ibrahim S. Association of hypertension, diabetes, stroke, cancer, kidney disease, and high-cholesterol with COVID-19 disease severity and fatality: A systematic review. Diabetes Metab Syndr. 2020;14(5):1133-1142. doi:10.1016/j.dsx.2020.07.005
  22. Zhu L, She ZG, Cheng X, et al. Association of Blood Glucose Control and Outcomes in Patients with COVID-19 and Pre-existing Type 2 Diabetes. Cell Metab. 2020;31(6):1068-1077.e3. doi:10.1016/j.cmet.2020.04.021
  23. Li G, Chen Z, Lv Z, Li H, Chang D, Lu J. Diabetes Mellitus and COVID-19: Associations and Possible Mechanisms. Kin T, ed. International Journal of Endocrinology. 2021;2021:1-10. doi:10.1155/2021/7394378
  24. Henry BM, Lippi G. Chronic kidney disease is associated with severe coronavirus disease 2019 (COVID-19) infection. Int Urol Nephrol. 2020;52(6):1193-1194. doi:10.1007/s11255-020-02451-9
  25. Marra F, Smolders EJ, El-Sherif O, et al. Recommendations for Dosing of Repurposed COVID-19 Medications in Patients with Renal and Hepatic Impairment. Drugs R D. 2021;21(1):9-27. doi:10.1007/s40268-020-00333-0
  26. Kollias A, Kyriakoulis KG, Dimakakos E, Poulakou G, Stergiou GS, Syrigos K. Thromboembolic risk and anticoagulant therapy in COVID‐19 patients: emerging evidence and call for action. Br J Haematol. 2020;189(5):846-847. doi:10.1111/bjh.16727
  27. Duo H, Li Y, Sun Y, et al. Effect of therapeutic versus prophylactic anticoagulation therapy on clinical outcomes in COVID-19 patients: a systematic review with an updated meta-analysis. Thrombosis Journal. 2022;20(1):47. doi:10.1186/s12959-022-00408-9



DOI: https://doi.org/10.22146/jmpf.84815

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