A Systematic Review of therapeutic agents for the treatment of the Middle East Respiratory Syndrome Coronavirus (MERS-CoV)
Identifieur interne : 000735 ( Main/Exploration ); précédent : 000734; suivant : 000736A Systematic Review of therapeutic agents for the treatment of the Middle East Respiratory Syndrome Coronavirus (MERS-CoV)
Auteurs : Hisham Momattin [Arabie saoudite] ; Anfal Y. Al-Ali [Arabie saoudite] ; Jaffar A. Al-Tawfiq [Arabie saoudite, États-Unis]Source :
- Travel Medicine and Infectious Disease [ 1477-8939 ] ; 2019.
Descripteurs français
- KwdFr :
- Animaux, Antiviraux (usage thérapeutique), Association médicamenteuse, Coronavirus du syndrome respiratoire du Moyen-Orient, Humains, Immunoglobuline G (usage thérapeutique), Infections à coronavirus (traitement médicamenteux), Interféron bêta (usage thérapeutique), Lopinavir (usage thérapeutique), Ritonavir (usage thérapeutique).
- MESH :
- traitement médicamenteux : Infections à coronavirus.
- usage thérapeutique : Antiviraux, Immunoglobuline G, Interféron bêta, Lopinavir, Ritonavir.
- Animaux, Association médicamenteuse, Coronavirus du syndrome respiratoire du Moyen-Orient, Humains.
English descriptors
- KwdEn :
- MESH :
- chemical , therapeutic use : Antiviral Agents, Immunoglobulin G, Interferon-beta, Lopinavir, Ritonavir.
- drug therapy : Coronavirus Infections.
- Animals, Drug Combinations, Humans, Middle East Respiratory Syndrome Coronavirus.
Abstract
The Middle East Respiratory Syndrome Coronavirus (MERS-CoV) was first described in 2012 and attracted a great international attention due to multiple healthcare associated outbreaks. The disease carries a high case fatality rate of 34.5%, and there is no internationally or nationally recommended therapy.
We searched MEDLINE, Science Direct, Embase and Scopus databases for relevant papers published till March 2019 describing in vitro, in vivo or human therapy of MERS.
Initial search identified 62 articles: 52 articles were from Medline, 6 from Embase, and 4 from Science Direct. Based on the inclusions and exclusions criteria, 30 articles were included in the final review and comprised: 22 in vitro studies, 8 studies utilizing animal models, 13 studies in humans, and one study included both in vitro and animal model. There are a few promising therapeutic agents on the horizon. The combination of lopinavir/ritonavir and interferon-beta- 1b showed excellent results in common marmosets and currently is in a randomized control trial. Ribavirin and interferon were the most widely used combination and experience comes from a number of observational studies. Although, the data are heterogenous, this combination might be of potential benefit and deserve further investigation. There were no randomized clinical trials to recommend specific therapy for the treatment of MERS-CoV infection. Only one such study is planned for randomization and is pending completion. The study is based on a combination of lopinavir/ritonavir and interferon-beta- 1b. A fully human polyclonal IgG antibody (SAB-301) was safe and well tolerated in healthy individuals and this agent may deserve further testing for efficacy.
Despite multiple studies in humans there is no consensus on the optimal therapy for MERS-CoV. Randomized clinical trials are needed and potential therapies should be evaluated only in such clinical trials. In order to further enhance the therapeutic aroma for MERS-CoV infection, repurposing old drugs against MERS-CoV is an interesting strategy and deserves further consideration and use in clinical settings.
Url:
DOI: 10.1016/j.tmaid.2019.06.012
PubMed: 31252170
PubMed Central: 7110863
Affiliations:
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Al-Ali</name><affiliation wicri:level="1"><nlm:aff id="aff2">Department of Pharmacy Services, Dhahran Eye Specialist Hospital, Dhahran, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Department of Pharmacy Services, Dhahran Eye Specialist Hospital, Dhahran</wicri:regionArea><wicri:noRegion>Dhahran</wicri:noRegion></affiliation></author><author><name sortKey="Al Tawfiq, Jaffar A" sort="Al Tawfiq, Jaffar A" uniqKey="Al Tawfiq J" first="Jaffar A." last="Al-Tawfiq">Jaffar A. Al-Tawfiq</name><affiliation wicri:level="1"><nlm:aff id="aff3">Infectious Disease Unit, Specialty Internal Medicine Department, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Infectious Disease Unit, Specialty Internal Medicine Department, Johns Hopkins Aramco Healthcare, Dhahran</wicri:regionArea><wicri:noRegion>Dhahran</wicri:noRegion></affiliation><affiliation wicri:level="2"><nlm:aff id="aff4">Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Medicine, Indiana University School of Medicine, Indianapolis, IN</wicri:regionArea><placeName><region type="state">Indiana</region></placeName></affiliation><affiliation wicri:level="2"><nlm:aff id="aff5">Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD</wicri:regionArea><placeName><region type="state">Maryland</region></placeName></affiliation></author></analytic><series><title level="j">Travel Medicine and Infectious Disease</title><idno type="ISSN">1477-8939</idno><idno type="eISSN">1873-0442</idno><imprint><date when="2019">2019</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Animals</term><term>Antiviral Agents (therapeutic use)</term><term>Coronavirus Infections (drug therapy)</term><term>Drug Combinations</term><term>Humans</term><term>Immunoglobulin G (therapeutic use)</term><term>Interferon-beta (therapeutic use)</term><term>Lopinavir (therapeutic use)</term><term>Middle East Respiratory Syndrome Coronavirus</term><term>Ritonavir (therapeutic use)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Animaux</term><term>Antiviraux (usage thérapeutique)</term><term>Association médicamenteuse</term><term>Coronavirus du syndrome respiratoire du Moyen-Orient</term><term>Humains</term><term>Immunoglobuline G (usage thérapeutique)</term><term>Infections à coronavirus (traitement médicamenteux)</term><term>Interféron bêta (usage thérapeutique)</term><term>Lopinavir (usage thérapeutique)</term><term>Ritonavir (usage thérapeutique)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antiviral Agents</term><term>Immunoglobulin G</term><term>Interferon-beta</term><term>Lopinavir</term><term>Ritonavir</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Coronavirus Infections</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Infections à coronavirus</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Antiviraux</term><term>Immunoglobuline G</term><term>Interféron bêta</term><term>Lopinavir</term><term>Ritonavir</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Animals</term><term>Drug Combinations</term><term>Humans</term><term>Middle East Respiratory Syndrome Coronavirus</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Animaux</term><term>Association médicamenteuse</term><term>Coronavirus du syndrome respiratoire du Moyen-Orient</term><term>Humains</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>The Middle East Respiratory Syndrome Coronavirus (MERS-CoV) was first described in 2012 and attracted a great international attention due to multiple healthcare associated outbreaks. The disease carries a high case fatality rate of 34.5%, and there is no internationally or nationally recommended therapy.</p></sec><sec><title>Method</title><p>We searched MEDLINE, Science Direct, Embase and Scopus databases for relevant papers published till March 2019 describing in vitro, in vivo or human therapy of MERS.</p></sec><sec><title>Results</title><p>Initial search identified 62 articles: 52 articles were from Medline, 6 from Embase, and 4 from Science Direct. Based on the inclusions and exclusions criteria, 30 articles were included in the final review and comprised: 22 in vitro studies, 8 studies utilizing animal models, 13 studies in humans, and one study included both in vitro and animal model. There are a few promising therapeutic agents on the horizon. The combination of lopinavir/ritonavir and interferon-beta- 1b showed excellent results in common marmosets and currently is in a randomized control trial. Ribavirin and interferon were the most widely used combination and experience comes from a number of observational studies. Although, the data are heterogenous, this combination might be of potential benefit and deserve further investigation. There were no randomized clinical trials to recommend specific therapy for the treatment of MERS-CoV infection. Only one such study is planned for randomization and is pending completion. The study is based on a combination of lopinavir/ritonavir and interferon-beta- 1b. A fully human polyclonal IgG antibody (SAB-301) was safe and well tolerated in healthy individuals and this agent may deserve further testing for efficacy.</p></sec><sec><title>Conclusion</title><p>Despite multiple studies in humans there is no consensus on the optimal therapy for MERS-CoV. Randomized clinical trials are needed and potential therapies should be evaluated only in such clinical trials. In order to further enhance the therapeutic aroma for MERS-CoV infection, repurposing old drugs against MERS-CoV is an interesting strategy and deserves further consideration and use in clinical settings.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Middle, W H O" uniqKey="Middle W">W.H.O. Middle</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Al Tawfiq, J A" uniqKey="Al Tawfiq J">J.A. Al-Tawfiq</name></author><author><name sortKey="Auwaerter, P G" uniqKey="Auwaerter P">P.G. Auwaerter</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Al Tawfiq, J A" uniqKey="Al Tawfiq J">J.A. Al-Tawfiq</name></author><author><name sortKey="Memish, Z A" uniqKey="Memish Z">Z.A. Memish</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Omrani, A S" uniqKey="Omrani A">A.S. 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Al-Ali</name><name sortKey="Al Tawfiq, Jaffar A" sort="Al Tawfiq, Jaffar A" uniqKey="Al Tawfiq J" first="Jaffar A." last="Al-Tawfiq">Jaffar A. Al-Tawfiq</name></country><country name="États-Unis"><region name="Indiana"><name sortKey="Al Tawfiq, Jaffar A" sort="Al Tawfiq, Jaffar A" uniqKey="Al Tawfiq J" first="Jaffar A." last="Al-Tawfiq">Jaffar A. Al-Tawfiq</name></region><name sortKey="Al Tawfiq, Jaffar A" sort="Al Tawfiq, Jaffar A" uniqKey="Al Tawfiq J" first="Jaffar A." last="Al-Tawfiq">Jaffar A. Al-Tawfiq</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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