新冠肺炎造成前所未有的全球大流行,然而目前並無有效藥物可以治療;瑞德西韋(remdesivir)被視為治療新冠肺炎的有效藥物,而奧司他偉(oseltamivir)目前並未被臨床證實有效,類固醇目前也不建議使用於治療新冠肺炎個案,此外,目前臨床資料也不建議新冠肺炎個案停止使用血管收縮素轉化酶抑制劑(angiotensin-converting enzyme inhibitors)或血管張力素受體拮抗劑(angiotensin receptor blockers)。隨著快速累積的研究發現以及臨床資料,未來將可提供臨床醫師治療新冠肺炎個案正確的參考。

(財團法人國家衛生研究院 蔡慧如博士摘要整理)

Importance:  The pandemic of coronavirus disease 2019 (COVID-19) caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) presents an unprecedented challenge to identify effective drugs for prevention and treatment. Given the rapid pace of scientific discovery and clinical data generated by the large number of people rapidly infected by SARS-CoV-2, clinicians need accurate evidence regarding effective medical treatments for this infection.

Observations:  No proven effective therapies for this virus currently exist. The rapidly expanding knowledge regarding SARS-CoV-2 virology provides a significant number of potential drug targets. The most promising therapy is remdesivir. Remdesivir has potent in vitro activity against SARS-CoV-2, but it is not US Food and Drug Administration approved and currently is being tested in ongoing randomized trials. Oseltamivir has not been shown to have efficacy, and corticosteroids are currently not recommended. Current clinical evidence does not support stopping angiotensin-converting enzyme inhibitors or angiotensin receptor blockers in patients with COVID-19.

Conclusions and Relevance:  The COVID-19 pandemic represents the greatest global public health crisis of this generation and, potentially, since the pandemic influenza outbreak of 1918. The speed and volume of clinical trials launched to investigate potential therapies for COVID-19 highlight both the need and capability to produce high-quality evidence even in the middle of a pandemic. No therapies have been shown effective to date.

Author:James M. Sanders, Marguerite L. Monogue, Tomasz Z. Jodlowski, et al.
原文連結:https://jamanetwork.com/journals/jama/fullarticle/2764727

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