- |||||||||| lopinavir/ritonavir / Generic mfg.
Clinical, Journal: Potential drug-drug interactions in COVID 19 patients in treatment with lopinavir/ritonavir. (Pubmed Central) - Sep 23, 2020
The independent variables associated with presenting ≥1 potential interactions were age (>65) (OR 1.95; 95% CI 1.06-3.59, P = .033), ICU admission (OR 9.22; CI 95% 1.98-42.93; P = .005), previous respiratory pathology (OR 2.90; 95% CI 1.15-7.36; P = .024), psychiatric (OR 4.14; 95 CI% 1.36-12.61; P = .013), dyslipidemia (OR 3.21; 95% CI 1.63-6.35; P = .001) and the number of drugs prescribed (OR 4.33; 95% CI 2.40-7.81; P = .000). The prevalence of potential interactions in COVD 19 patient undergoing treatment with LPV/r is high, with age (>65), ICU admission, previous respiratory and psychiatric pathology, dyslipidemia and the number of prescribed drugs acting as risk factors.
- |||||||||| Clinical, Journal: Therapeutic Options in the Treatment of SARS-CoV-2 in the Pregnant Patient. (Pubmed Central) - Sep 23, 2020
To date, there have been no published review of therapeutics in the pregnant patient infected with SARS-CoV-2. We provide the first review of available treatments for SARS-CoV-2, various trials with inclusion and exclusion of the pregnant patients, and potential side effects of each treatment in the pregnant patient.
- |||||||||| Clinical, Review, Journal: An overview of safety assessment of the medicines currently used in the treatment of COVID-19 disease. (Pubmed Central) - Sep 20, 2020
Thus, the aim of this study was to review and evaluate the literature data on the toxicity of the selected individual drugs (ritonavir, lopinavir, remdesivir, chloroquine, and umifenovir) and the available clinical data concerning the possible adverse effects of the selected drug combinations (lopinavir/ritonavir+umifenovir, lopinavir/ritonavir+interferon β, chloroquine+remdesivir, and chloroquine+azithromycin). The most often reported toxic effects of these medicines such as hepatotoxicity, retinal damage, nephrotoxicity, and cardiotoxicity, together with the fact that the health status of the patients with COVID-19 disease is often complicated by co-existing illnesses and therapy implicate that the decision on the therapeutic strategy should be made with caution.
- |||||||||| Avastin (bevacizumab) / Roche, ritonavir / Generic mfg.
Review, Journal: Virology, pathogenesis, diagnosis and in-line treatment of COVID-19. (Pubmed Central) - Sep 18, 2020
This review work highlighted the origin, emergence, structural features, pathogenesis, and clinical features of COVID-19. We have also discussed the in-line treatment strategies, preventive measures, and vaccines to combat the emergence of COVID-19.
- |||||||||| chloroquine phosphate / Generic mfg., hydroxychloroquine / Generic mfg., lopinavir/ritonavir / Generic mfg.
Clinical, Review, Journal: A Systematic Review of Treatment and Outcomes of Pregnant Women With COVID-19-A Call for Clinical Trials. (Pubmed Central) - Sep 18, 2020
The large number of clinical trials excluding pregnant persons, despite interventions with safety data in pregnancy, is concerning. In addition to observational cohort studies, pregnancy-specific adaptive clinical trials could be designed to identify safe and effective treatments.
- |||||||||| lopinavir/ritonavir / Generic mfg.
Trial completion date, Trial initiation date, Trial primary completion date: Lopinavir/Ritonavir for the Treatment of COVID-19 Positive Patients With Cancer and Immune Suppression in the Last Year (clinicaltrials.gov) - Sep 17, 2020
P2, N=75, Not yet recruiting,
In addition to observational cohort studies, pregnancy-specific adaptive clinical trials could be designed to identify safe and effective treatments. Trial completion date: Jul 2021 --> Nov 2021 | Initiation date: Jul 2020 --> Nov 2020 | Trial primary completion date: Jul 2021 --> Nov 2021
- |||||||||| ritonavir / Generic mfg.
Journal: Signal amplification by reversible exchange for COVID-19 antiviral drug candidates. (Pubmed Central) - Sep 16, 2020
Chloroquine, hydroxychloroquine, ritonavir/lopinavir, and favipiravir are under trials for the treatment of this disease...We can expect further research on the hyperpolarization of other important large molecules, isotope labeling, as well as polarization transfer on nuclei with a long spin relaxation time. A clinical perspective of these features on drug molecules can broaden the application of hyperpolarization techniques for therapeutic studies.
- |||||||||| hydroxychloroquine / Generic mfg., dexamethasone / Generic mfg.
Review, Journal: Hydroxychloroquine and dexamethasone in COVID-19: who won and who lost? (Pubmed Central) - Sep 16, 2020
Hydroxychloroquine or chloroquine have been widely adopted worldwide for the treatment of SARS-CoV-2 pneumonia...Recently, four large Randomized Controlled Trials (RCTs) have been performed in record time delivering reliable data: (1) the National Institutes of Health (NIH) RCT included 60 hospitals participating all over the world and showed the efficacy of remdesivir in reducing the recovery time in hospitalized adults with COVID-19 pneumonia; (2) three large RCTs already completed, for hydroxychloroquine, dexamethasone and Lopinavir and Ritonavir respectively...The results of these four large RCTs have provided sound indications to doctors for the treatment of patients with COVID-19 and prompted the correction of many institutional provisions and guidelines on COVID-19 treatments (i.e. FDA, NIH, UK Health Service, etc.). Even though a definitive treatment for COVID-19 has not yet been found, large RCTs stand as the Gold Standards for COVID-19 therapy and offer a solid scientific base on which to base treatment decisions.
- |||||||||| Actemra IV (tocilizumab) / Roche, JW Pharma
[VIRTUAL] Hemochromatosis in a Patient With Coronavirus Disease 2019 () - Sep 15, 2020 - Abstract #ACG2020ACG_2834;
Severe COVID-19 in this patient unmasked underlying hemochromatosis due to elevation in ferritin secondary to acute viral infection. Reporting cases like this will help understand effect of COVID-19 on underlying iron overload diseases.
- |||||||||| lopinavir/ritonavir / Generic mfg.
Review, Journal: Lopinavir-Ritonavir in SARS-CoV-2 Infection and Drug-Drug Interactions with Cardioactive Medications. (Pubmed Central) - Sep 13, 2020
Many cardiology, pulmonology, and intensivist physicians have never been exposed to clinical scenarios requiring co-prescription of cardiac and antiviral therapies. Therefore, it is essential to enumerate these drug-drug interactions, to avoid any serious drug toxicity, to consider alternate and safer drugs, and to ensure better patient care.
- |||||||||| Actemra IV (tocilizumab) / Roche, JW Pharma
Clinical, Retrospective data, Journal: Tocilizumab for severe COVID-19 pneumonia: Case series of 5 Australian patients. (Pubmed Central) - Sep 12, 2020
Tocilizumab use was associated with favorable clinical outcome in our patients. We recommend tocilizumab be included in randomized controlled trials of treatment for patients with severe COVID-19 pneumonia, and be considered for compassionate use in such patients pending the results of these trials.
- |||||||||| Preclinical, Journal: Comparative Antiviral Efficacy of Viral Protease Inhibitors against the Novel SARS-CoV-2 In Vitro. (Pubmed Central) - Sep 12, 2020
This research concluded that lopinavir/ritonavir should be stopped for clinical use due to the huge gap between in vitro IC and free plasma concentration. Nevertheless, the structure-activity relationship analysis of the four inhibitors provided further information for de novel design of future viral protease inhibitors of SARS-CoV-2.
- |||||||||| ritonavir / Generic mfg.
Clinical, Journal: Peripapillary Retinal Vascular Involvement in Early Post-COVID-19 Patients. (Pubmed Central) - Sep 12, 2020
RNFL average thickness was linearly correlated to RPCP-FI and RPCP-PD within post-COVID-19 group. Future studies will be needed to address the hypothesis of a microvascular retinal impairment in individuals who recovered from SARS-CoV-2 infection.
- |||||||||| Actemra IV (tocilizumab) / Roche, JW Pharma, fondaparinux / Generic mfg., ritonavir / Generic mfg.
[VIRTUAL] Importance of anticoagulation in a patient with COVID 19. () - Sep 12, 2020 - Abstract #EUSEM2020EUSEM_646;
As the only personal history was hypertension treated with enalapril / hydrochlorothiazide 20 / 1.5mg and a carotid stenosis of 70% in treatment with adiro 100mg...Given these findings, outpatient treatment is started with hydroxychloroquine 200 mg 1 tablet every 12 hours, lopinavir / ritonavir 100/25 mg 1 tablet every 12 hours and 1 azithromycin 500 mg tablet for 3 days is started...During admission, the patient is treated with immunomodulatory treatment with tocilizumab 600 mg twice and methylprednisone 250 mg bolus for 3 days...Baricitinib is stopped on the 6th day of treatment as the patient makes a significant increase in transaminases...BMJ Best Practice stresses the importance of identifying high-risk COVID-19 patients in order to establish VTE prophylaxis measures, in turn the "American Society of Hematology" recommends pharmacological thromboprophylaxis with LMWH or fondaparinux in hospitalized patients with COVID-19, unless the patient is considered to be at increased risk of bleeding...The Spanish national health system indicates that in patients without anticoagulant treatment prior to infection but who are considered a patient at thrombotic risk due to COVID-19 infection, LMWH would be prescribed at prophylactic doses during admission and continued at discharge for a time ranging from 7-15 days and one month (to take into account the individual situation of each patient). However, more studies are needed on the need for anticoagulation in patients with COVID-19
- |||||||||| ceftriaxone / Generic mfg., amoxicillin / Generic mfg.
[VIRTUAL] Emergent intervention on retirement houses because of covid-19. Was it worth it? () - Sep 12, 2020 - Abstract #EUSEM2020EUSEM_558;
SARS-COV-2 PCR result, date of result, symptoms, treatments applied (antibiotics, hydroxychloroquine, lopinavir/ritonavir, corticosteroids, anticoagulation, supplemental oxygen therapy), follow-up, need of inhospital admission due to complications, deceases before and after intervention (date and causes)...Antibiotics: azithromycin 85%, amoxicillin 30%, ceftriaxone 35%, hydroxychloroquine 20%, anticoagulation with low-weight molecular heparin (LMWH) 70%, corticosteroids 90%, oxygen therapy 50%...CONCLUSIONS Use of curative treatments at nursing homes, under the direction of emergency physicians has led to an improvement in the survival of these patients, without contributing to the collapse of hospitals during pandemic. Surprisingly, a large number of this high-risk population has a asymptomatic infection
- |||||||||| lopinavir/ritonavir / Generic mfg.
[VIRTUAL] Efficacy of Lopinavir / ritonavir in a patient with COVID 19. () - Sep 12, 2020 - Abstract #EUSEM2020EUSEM_537;
As the only personal history was hypertension treated with enalapril / hydrochlorothiazide 20 / 1.5mg and a carotid stenosis of 70% in treatment with adiro 100mg...Given these findings, outpatient treatment is started with hydroxychloroquine 200 mg 1 tablet every 12 hours, lopinavir / ritonavir 100/25 mg 1 tablet every 12 hours and 1 azithromycin 500 mg tablet for 3 days is started...During admission, the patient is treated with immunomodulatory treatment with tocilizumbag 600 mg twice and methylprednisone 250 mg bolus for 3 days...Baricitinib is stopped on the 6th day of treatment as the patient makes a significant increase in transaminases...It can be concluded that there is no scientific evidence that significantly supports the use of lopinavir/ritonavir in patients with covid infection 19. More studies are needed on its efficacy in this type of patient
- |||||||||| hydroxychloroquine / Generic mfg., Actemra IV (tocilizumab) / Roche, JW Pharma, ritonavir / Generic mfg.
[VIRTUAL] Efficacy of hydroxychloroquine in a patient with COVID 19. () - Sep 12, 2020 - Abstract #EUSEM2020EUSEM_535;
The patient made partial improvement, so it was decided to start treatment with baricitinib 4 mg for 7 days...The Kaplan-Meier estimate for the "negative conversion rate" (negative in Covid-19) was 85.4 percent in the hydroxychloroquine plus standard of care (SOC) group, compared to 81.3 percent in the SOC-only group (P=0.34). More studies are needed on the effect of chloroquine in patients with covid 19+
- |||||||||| Actemra IV (tocilizumab) / Roche, JW Pharma, ritonavir / Generic mfg.
[VIRTUAL] Efficacy of corticosteroids in a patient with COVID 19. () - Sep 12, 2020 - Abstract #EUSEM2020EUSEM_534;
However, these data are fundamentally flawed and the new data collected prospectively should shed light on this controversial issue. More studies are needed on the efficacy of corticosteroids in patients with COVID-19 infection
- |||||||||| Actemra IV (tocilizumab) / Roche, JW Pharma, Kineret (anakinra) / SOBI, Affibody, ritonavir / Generic mfg.
[VIRTUAL] Efficacy of Anakinra in a patient with COVID 19. () - Sep 12, 2020 - Abstract #EUSEM2020EUSEM_532;
As the only personal history was hypertension treated with enalapril / hydrochlorothiazide 20 / 1.5mg and a carotid stenosis of 70% in treatment with adiro 100mg...Given these findings, outpatient treatment is started with hydroxychloroquine 200 mg 1 tablet every 12 hours, lopinavir / ritonavir 100/25 mg 1 tablet every 12 hours and 1 azithromycin 500 mg tablet for 3 days is started...During admission, the patient is treated with immunomodulatory treatment with tocilizumab 600 mg twice and methylprednisone 250 mg bolus for 3 days...Baricitinib is stopped on the 6th day of treatment as the patient makes a significant increase in transaminases...Data from a phase 3 randomized controlled trial of IL-1 blockade with Anakinra in sepsis with SAM characteristics showed a significant improvement in the 28-day survival rate (65.4% Anakinra vs. 35.3% placebo), with HR of fatal outcome of 0.28 (0.11–0.71, p = 0.0071), with no increased adverse events, thus Anakinra could have potential use to reduce systemic inflammation and lung damage caused by SARS-CoV2 without this being demonstrated in trials clinics to date. Still, more studies are needed on the efficacy of anakinra in patients with COVID- 19
- |||||||||| hydroxychloroquine / Generic mfg., azithromycin / Generic mfg., lopinavir/ritonavir / Generic mfg.
Clinical, Journal: Viral exanthema as manifestation of SARS-CoV-2 infection: A case report. (Pubmed Central) - Sep 11, 2020
Identifying the different manifestations is useful for understanding the extent of SARS-CoV-2 infection. We not only present a rare manifestation but also suggest that cutaneous manifestations may correlate with immunity.
- |||||||||| remdesivir / Generic mfg., hydroxychloroquine / Generic mfg., lopinavir/ritonavir / Generic mfg.
Clinical, Journal: Respuestas rápidas a la pandemia de COVID-19 a través de la ciencia y la colaboración global: el ensayo clínico Solidaridad. (Pubmed Central) - Sep 10, 2020
SOLIDARITY is a mega clinical trial that recruited thousands of subjects with moderate to severe disease, who were randomly assigned to one of the treatment groups under evaluation, including hydroxychloroquine, lopinavir/ritonavir associated or not with interferon; or remdesivir compared to standard therapy. Peru has joined the list of countries where the trial will be reproduced, through which it will be possible to quickly identify if any of these drugs offers a real benefit to patients.
- |||||||||| Journal: Antiviral therapy for coronavirus disease 2019. (Pubmed Central) - Sep 10, 2020
Hot anti-SARS-CoV-2 drugs include interferon α, ribavirin, lopinavir/ritonavir, chloroquine phosphate, abidol, as well as hydroxychloroquine sulfate and remdesivir. But the later 2 drugs aren't mentioned in the Seventh Version of Diagnosis and Treatment Plan.
- |||||||||| Actemra IV (tocilizumab) / Roche, JW Pharma, Soliris (eculizumab) / Alexion Pharma
Review, Journal: COVID-19: review on latest available drugs and therapies against SARS-CoV-2. Coagulation and inflammation cross-talking. (Pubmed Central) - Sep 9, 2020
The inflammatory phase includes therapeutic options like Tocilizumab, Anakinra, Baricitinib, Eculizumab, Emapalumab and Heparin...Coagulopathy is a common complication in severe cases, inflammation and coagulation are intertwined and cross-talking between these two responses is known to happen. A possible amplification of this cross-talking is suggested to be implicated in the severe cases that show both a cytokine storm and coagulopathy.
- |||||||||| Clinical, Review, Journal: Cathepsin L-selective inhibitors: A potentially promising treatment for COVID-19 patients. (Pubmed Central) - Sep 4, 2020
Current treatment of COVID-19 patients relies mainly on antiviral drugs lopinavir/ritonavir, arbidol, and remdesivir, the anti-malarial drugs hydroxychloroquine and chloroquine, and traditional Chinese medicine...We identify ten US FDA-approved drugs that have CatL inhibitory activity. We provide evidence that supports the combined use of serine protease and CatL inhibitors as a possibly safer and more effective therapy than other available therapeutics to block coronavirus host cell entry and intracellular replication, without compromising the immune system.
- |||||||||| Clinical, Review, Journal: Clinical trials of repurposed antivirals for SARS-CoV-2. (Pubmed Central) - Sep 4, 2020
Unfortunately, the first open-label, randomized controlled trials are showing the poor efficacy of these repurposed drugs. These results highlight the necessity of identifying and characterizing specific and potent SARS-CoV-2 antivirals.
- |||||||||| hydroxychloroquine / Generic mfg., Actemra IV (tocilizumab) / Roche, JW Pharma
Retrospective data, Journal: Effect of Systemic Inflammatory Response to SARS-CoV-2 on Lopinavir and Hydroxychloroquine Plasma Concentrations. (Pubmed Central) - Sep 4, 2020
Lopinavir-ritonavir was administered every 12 hours, 800/200 mg on day 1 and 400/100 mg on day 2 until day 5 or 7...LPV plasma concentrations positively correlated with CRP values (r = 0.37, P < 0.001) and were significantly lower when tocilizumab was preadministered...The ratio of calculated unbound drug fraction to published SARS-CoV-2 EC50 values indicated insufficient LPV concentrations in the lung. CRP values significantly correlated with LPV but not HCQ plasma concentrations, implying inhibition of cytochrome P450 3A4 (CYP3A4) metabolism by inflammation.
- |||||||||| Clinical, Journal: Efficacy and safety of interferon β-1a in treatment of severe COVID-19: A randomized clinical trial. (Pubmed Central) - Sep 4, 2020
CRP values significantly correlated with LPV but not HCQ plasma concentrations, implying inhibition of cytochrome P450 3A4 (CYP3A4) metabolism by inflammation. Although IFN did not change time to reach the clinical response, adding it to the national protocol significantly increased discharge rate on day 14 and decreased 28-day mortality.
- |||||||||| lopinavir/ritonavir / Generic mfg.
Clinical, PK/PD data, Journal: Pharmacokinetics of lopinavir/ritonavir oral solution to treat COVID-19 in mechanically ventilated ICU patients. (Pubmed Central) - Sep 4, 2020
In mechanically ventilated patients with severe COVID-19 infections, the oral administration of lopinavir/ritonavir elicited plasma exposure of lopinavir more than 6-fold the upper usual expected range. However, it remains difficult to safely recommend its dose reduction without compromising the benefit of the antiviral strategy, and careful pharmacokinetic and toxicity monitoring are needed.
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