新型冠状病毒肺炎口服药物莫诺拉韦及其对比分析

Molnupiravir—an oral drug for COVID-19 and its comparative analysis

目的:综述莫诺拉韦药物作用机制、药动学、有效性、安全性、相互作用等,为临床用药提供依据。方法:系统检索中国临床试验注册中心、clinicaltrials.gov、PubMed、中国期刊全文数据库(CNKI)、万方数据库中莫诺拉韦相关文献并综述相关信息。结果与结论:莫诺拉韦是全球首个用于新型冠状病毒肺炎(COVID-19)的小分子口服药物,目前已在40多个国家获批或获得紧急使用授权。莫诺拉韦是抗病毒核糖核苷类似物,可通过病毒RNA聚合酶导致RNA产物突变,中止病毒复制。临床数据显示莫诺拉韦可降低轻、中症COVID-19患者的住院率及病死率,并对新型冠状病毒(SARS-CoV-2)突变株可能有效。该药物具有较好的安全性和耐受性,为未来COVID-19治疗提供参考。

Objective: The mechanism of action, metabolic kinetics, efficacy, safety and drug-drug interaction of molnupiravir were reviewed to provide a basis for clinical use. Methods: Literature related to molnupiravir was systematically searched in Chinese Clinical Trial Registry, clinicaltrials.gov, Pubmed, Chinese Journal Full-text Database(CNKI) and Wanfang database, and the relevant information was reviewed. Results & Conclusions: Molnupiravir was the world’s first small-molecule oral drug for COVID-19, which had been approved or authorized for emergency use in more than 40 countries all over the world. Molnupiravir was a ribonucleoside analogue that could be caused mutations in RNA products by viral RNA polymerase, and thus halt viral replication. Clinical trial results showed that molnupiravir could be reduced hospitalization and mortality rates in patients with mild and moderate COVID-19, and might be effective against SARS-CoV-2 mutant strains.Molnupiravir had good safety and tolerability, to provide reference for the treatment of COVID-19 in the future.