RECENT STUDIES ON ARBIDOL
June 24, 2020
Recent Studies on Arbidol
Recently, the COVID-19 epidemic broke out all over the world. The virus appeared to be highly infectious. There are more than 8 million infected people and over 400 thousand fatal cases. From March 2020 the life world-wide was literally paralyzed. The borders between the countries were shut down and the global trade immensely decreased. The damage to the world economy has been estimated in billions of dollars.
All the states are interested in combating this challenge while scientists of all countries keep looking for various medications and vaccines against SARS-COV-2. There is currently very limited evidence to support the use of any existing medications for the treatment of COVID-19. Several ones have been proposed as likely candidates. There are currently clinical trials both within China where the virus originated and internationally, to test their efficacy and safety. Most of the drug options come from the experience of treating SARS, MERS, and other influenza. Broadly, the medication classes that may help manage patients with COVID-19 include:
- Antimalarial drugs (such as chloroquine and hydroxychloroquine);
- Antivirals (such as favipiravir, umifenovir, remdesivir);
- Antiretrovirals (such as Ritonavir + Lopinavir);
- Immune modulators (Interferon α, β, γ or λ);
- Biologic Disease-Modifying Anti-Rheumatic Drugs (Interleukin-6 inhibitors).
In this article, we would like to focus on recent studies devoted to the antiviral drug Arbidol (Umifenovir), which was originally designated to combat seasonal influenza and which has been used in China in combination with other medications to treat patients with COVID-19 from the very outbreak of the pandemic. It has shown the potential to inhibit viruses from many different families and found to be effective for COVID-19 in vitro. Arbidol is currently included in the recommended antivirus regimen in the Diagnosis and Treatment of Pneumonia Caused by 2019-nCoV issued by the National Health Commission of the People’s Republic of China.
The Ministry of Health of the Russian Federation also includes Arbidol (Umifenovir) in the dosage of 200mg 4 times a day, for 5-7 days for the treatment of mild forms of the disease along with hydroxychloroquine, interferon α, etc.
RITONAVIR/LOPINAVIR + ARBIDOL
A group of researchers from Lishui Hospital of Zhejiang University conducted a study aiming to evaluate the antiviral efficacy of Lopinavir/Ritonavir alone or combined with Arbidol in the treatment of hospitalized patients with common coronavirus disease-19.
In this retrospective observational study, the treatment of Lopinavir/Ritonavir combined with Arbidol did not significantly accelerate the main symptoms of improvement although the median time of hospital stay was slightly shorter in group-Ritonavir/Lopinavir + Arbidol.
However, another study that evaluated antiviral effects and safety of Lopinavir/Ritonavir vs Arbidol in patients with the 2019-nCoV disease has shown quite opposite results. On day 14 after the admission, no viral load was detected in the Arbidol group, but the viral load was found in 44.1% of patients treated with Lopinavir/Ritonavir. Patients in the Arbidol group had a shorter duration of positive RNA test compared to those in another group. This allowed the researchers to conclude that Arbidol monotherapy might be superior to Lopinavir/Ritonavir in treating COVID-19.
Another recent study has been conducted based on the hypothesis that Arbidol combined with interferon might have a synergistic therapeutic effect against coronavirus since Arbidol could induce interferon and immune cells. Between January 2019 and March 2020, a total of 141 patients with COVID-19 included in the cohort were treated with Arbidol/IFN-α2b or IFN-α2b alone. The results have demonstrated that Arbidol/IFN-α2b combination was not associated with a decreased hospitalization or accelerated COVID-19 RNA clearance when compared with IFN-α2b monotherapy.
ARBIDOL AND MOXIFLOXACIN
Scientists of Nanchang University aimed to investigate the therapeutic effect of Arbidol (100mg each time, three times a day for 14 days) and Moxifloxacin (0.4g each time, once a day for 7-14 days) in 94 patients infected with SARS-CoV-2. In summary, it has been proven that the treatment with Arbidol and Moxifloxacin could be helpful in reducing viral load and inflammation, especially in regulating fatal inflammation in severe COVID-19 patients.
FAVIPIRAVIR VS ARBIDOL
Chinese experts also compared Russian Arbidol and Japanese drug Favipiravir in a prospective, randomized, and controlled, open-label multicenter trial involving 240 adult patients with COVID-19. Patients were randomly assigned in a 1:1 ratio to receive conventional therapy plus Umifenovir (Arbidol) or Favipiravir for 10 days. The clinical recovery rate of day 7 did not significantly differ between the Favipiravir group (71/116) and the Arbidol group (62/120). Although the Japanese medicine led to shorter latencies to relief for both pyrexia and cough, the most frequently observed Favipiravir-associated adverse event was raised serum uric acid. Unlike Favipiravir, Arbidol showed a more favorable safety profile.
Most of the evidence presented recently still strives for further clinical verification. Due to safety concerns, and the unknown effects of prescribing any medications for off-label usage, such as for COVID-19 infection, there are still no strict recommendations on how to treat patients with mild to moderate COVID-19 illness. It is neither recommended to use any of the medications for prevention purposes. Existing medications can continue to play a role in the management of patients infected with COVID-19, but only if being prescribed by a doctor.
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