世衛再度質疑瑞德西韋,不建議使用該葯治療新冠患者

2020-11-21 06:20:14 1007 views
摘要

瑞德西韋國外新冠疫情第二波來襲,對於被美國人認為是“神葯”的瑞德西韋,世界衛生組織(WHO)再次提出了警告。當地時間20日,世界衛生組織的指南制定小組(GDG)建議不要將瑞德西韋用於治療新冠肺炎住院患者,無論患者病情嚴重程度如何。

世衛再度質疑瑞德西韋,不建議使用該葯治療新冠患者

瑞德西韋

國外新冠疫情第二波來襲,對於被美國人認為是「神葯」的瑞德西韋,世界衛生組織(WHO)再次提出了警告。

當地時間20日,世界衛生組織的指南制定小組(GDG)建議不要將瑞德西韋用於治療新冠肺炎住院患者,無論患者病情嚴重程度如何。通過對比幾種藥物對新冠肺炎的治療效果,目前沒有任何證據證明瑞德西韋有助於提升患者的存活率,或降低他們依賴呼吸機的概率。

Gilead's drug remdesivir is not recommended for patients hospitalized with COVID-19, regardless of how ill they are, as there is no evidence it improves survival or reduces the need for ventilation, a World Health Organization (WHO) panel said on Friday.

在世衛組織提出此次建議之前,歐洲重症監護醫學會(ESICM)的醫生就已建議瑞德西韋等抗病毒藥物不應用於治療重症監護病房的新冠肺炎患者。

事實上,近幾個月,關於瑞德西韋對治療新冠肺炎患者的效用一直是存在爭議的話題。

瑞德西韋也是美國總統特朗普確診感染新冠後所使用的藥物之一。此前有研究顯示,這種藥物可縮短康復時間。隨之,該藥物被50多個國家授權或批准用於新冠肺炎治療。

The latest WHO advice comes after one of the world's top bodies representing intensive care doctors said the antiviral should not be used for COVID-19 patients in critical care wards.

The medication was one of the drugs used to treat U.S. President Donald Trump's coronavirus infection, and had been shown in previous studies to have cut time to recovery. It is authorized or approved for use as a COVID-19 treatment in more than 50 countries.

世衛再度質疑瑞德西韋,不建議使用該葯治療新冠患者

世衛組織指南制定小組表示,其建議是基於評估和對比幾種新冠藥物療效後而得出的結論,該評估數據涉及四項國際隨機試驗中的7000名新冠肺炎住院患者。

在徹底審查這一證據之後,指南制定小組的專家們表示,瑞德西韋對新冠患者的死亡率和患者的其他重要後果,例如對呼吸機或臨床改善時間的需求,沒有顯著的影響。

除此以外,該小組的專家們還認為該藥物存在重大危害的可能性,以及使用成本高、操作複雜等問題,如該葯必須通過靜脈注射。

然而,專家們表示,他們仍會支持繼續開展評估瑞德西韋的試驗,因為繼續試驗將會向特定患者群體提供更高的證據確定性。

The WHO's Guideline Development Group (GDG) panel said its recommendation was based on an evidence review that included data from four international randomized trials involving more than 7,000 patients hospitalized with COVID-19.

After reviewing the evidence, the panel said, it concluded that remdesivir, which has to be given intravenously and is therefore costly and complex to administer, has no meaningful effect on death rates or other important outcomes for patients.

"The ... panel found a lack of evidence that remdesivir improved outcomes that matter to patients such as reduced mortality, need for mechanical ventilation, time to clinical improvement, and others," the WHO guideline said.

"Especially given the costs and resource implications associated with remdesivir ...the panel felt the responsibility should be on demonstrating evidence of efficacy, which is not established by the currently available data," it added.

The panel said, however, that it supported continued enrollment into clinical trials evaluating remdesivir in patients with COVID-19, which it said should "provide higher certainty of evidence for specific groups of patients."

值得一提的是,世界衛生組織的建議不具有約束力,只是其「生存指南」項目中的一部分。該指南的制定旨在為新冠病例的管理提供值得信賴的指導,並幫助醫生與患者做出更好的決定。

此外,該指南在諸如新冠大流行這樣的快速發展的研究領域中很有用,它使研究人員可以在獲得新信息時更新先前經過審查和同行評審的證據和信息。

The WHO's recommendation, which is not binding, is part of its "living guidelines" project, designed to offer guidance for doctors to help them make clinical decisions about patients in fast-moving situations such as the COVID-19 pandemic. The guidelines can be updated and reviewed as new evidence and information emerges.

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