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Nhasi, mushonga wekuChina wakazvigadzira wega placebo-inodzorwa nemorekuru mushonga, Zenotevir, uri mubhodhi. NEJM> . Chidzidzo ichi, chakaburitswa mushure mekupera kweCCIDID-19 denda uye denda rapinda muchikamu chitsva chedenda, rinoratidza maitiro ekutsvagisa ekiriniki emushonga wakatangwa panguva yedenda, uye inopa chiitiko chakanaka chekubvumidzwa kwekukurumidzira kwekubuda kwezvirwere zvitsva zvinotapukira.

Huwandu hwehurwere hunokonzerwa nehutachiona hwehutachiona hwekufema hwakakura, kusanganisira hutachiona hwehutachiona, hutachiona hwechiratidzo (zvinyoro kusvika pakati pezviitiko pasina kuchipatara), zvakanyanya (zvinoda kuchipatara), uye kufa. Zvingave zvakanaka kana zviyero izvi zvekutariswa kwekiriniki zvichikwanisa kuverengerwa mukuyedzwa kwekiriniki kuti vaone kubatsira kwemushonga unodzivirira hutachiona, asi kune dhiri riri kuramba risinganyanyi kushata mukati medenda, zvakakosha kuti usarudze chekutanga chekiriniki chinotariswa uye kunyatsoongorora kushanda kwemushonga unodzivirira hutachiona.

Zvinangwa zvekutsvagisa zvemishonga inorwisa hutachiona zvinogona kukamurwa kuita kuderedza kufa, kukurudzira kuvandudzwa kwechirwere chakakomba, kuderedza chirwere chakakomba, kupfupisa nguva yezviratidzo uye kudzivirira kutapukira. Pamatanho akasiyana edenda, magumo ekiriniki anosarudzwa anowanzosiyana zvakanyanya. Parizvino, hapana Covid-19 antiviral yakaratidzwa kuva yakanaka mukuderedza kufa uye kukurudzira kuregererwa kwakanyanya.

Pamishonga inorwisa utachiona hweCOVID-19, Nematavir/Ritonavir yakaita EPIC-HR (NCT04960202) [1], EPIC-SR (NCT05011513) uye EPIC-PEP (NCT05047601) miedzo yekiriniki, zvichiteerana. Zvinangwa zvitatu zvaive zvekudzikisa chirwere chakakomba, kupfupisa nguva yezviratidzo uye kudzivirira kutapukirwa. Nematavir/ritonavir yakangoratidzwa neEPIC-HR kuderedza kurwara kwakanyanya, uye hapana mhedzisiro yakanaka yakawanikwa kune maviri ekupedzisira.

Neshanduko yeCCIDID-19 denda dhizaini kuita omicron uye kuwedzera kwakakosha kweyero yekudzivirira, chiitiko chekutakurwa kwehuremu mumapoka ane njodzi zvakanyanya kudzikira, uye zvakaoma kuwana mhedzisiro nekutora dhizaini yekuyedza yakafanana neEPIC-HR nehuremu hwekufambisa senge yekupedzisira. Semuyenzaniso, NEJM yakaburitsa ongororo yekuenzanisa yeVV116 maringe neNematavir/Ritonavir [2] inoratidza kuti yekutanga haina kushata kupfuura iyo yekupedzisira maererano nenguva yekuramba kupora kwekiriniki muvakuru vane hunyoro kusvika pakati nepakati Covid-19 vari panjodzi yekufambira mberi. Zvisinei, chirongwa chekutanga chechipatara cheVV116 chakashandisa kushanduka kwehuremu sechidzidzo chekupedzisira, uye nekukurumidza kushanduka kwechirwere, zvakanga zvakaoma kutarisa nhamba inotarisirwa yezviitiko. Zvidzidzo izvi zvinoratidza kuti nzira yekuongorora kushanda kwekiriniki yemishonga mitsva uye ndeipi yekutanga magumo inofanira kushandiswa sechiyero chekuongorora kwehutano chave chakakosha matambudziko ekutsvakurudza kwekliniki munyaya yekukurumidza kushanduka kwechirwere, kunyanya kukurumidza kuderedzwa kwehuwandu hwekushandura uremu.

Muyedzo weNematavir/Ritonavir EPIC-SR, uyo wakatora zviratidzo gumi nemana zveCCIDID-19 uye wakashandisa nguva yekugadziriswa kwechiratidzo semagumo, wakaburitsawo zvakaipa. Tinogona kuita fungidziro nhatu: 1. Maitiro ekushanda akavimbika, zvinoreva kuti nematavir haishande mukuvandudza zviratidzo zvekiriniki zveCOVID-19; 2. Mishonga inoshanda, asi mitemo yekushanda haina kuvimbika; 3. Chiyero chekushanda hachina kuvimbika, uye mushonga wacho haunawo kushanda muchiratidzo ichi.

Sezvo China yakazvimiririra inovandudza Covid-19 antiviral mishonga inofamba kubva murabhoritari ichienda kukiriniki kuyedzwa nhanho, takatarisana nedambudziko rakakosha - kushomeka kwemaitiro ekuongorora ekiriniki. Zvinonyatsozivikanwa kuti chinhu chimwe nechimwe chakakosha chekugadzirwa kwekiriniki kuyedzwa kwakarurama, uye zvinokwanisika kuratidza kushanda kwemushonga. Mafungiro emhedzisiro iyi yakaipa anotarisisa kana mishonga yeChina yakazvimiririra yekuvandudza inogona kubudirira.

Kana nguva yekunyangarika kwezviratidzo zveCovid-19 isiri magumo akakodzera ekuongorora anti-SARS-CoV-2 mishonga, zvinoreva kuti mishonga yeChina yakazvimiririra inogona kungoramba ichiongorora nekudzikisa huremu kuratidza kushanda kwayo, uye mugwagwa uyu wekutsvagisa nebudiriro uchapedzwa mushure mekunge denda rapedza hutachiona hwepasirese uye kusadzivirirwa kwemombe kwakadzikwa zvishoma nezvishoma. Iwindo rekuzadzisa zvinangwa zvekutsvagisa zvekiriniki nehuremu huremu sezvo magumo ekutanga ari kuvhara.

Musi wa18 Ndira, 2023, chikamu 2-3 chekiriniki kuyedzwa kwekurapa kwehunyoro-yepakati novel coronavirus hutachiona neCenotevir yakaitwa naCao Bin et al. yakabudiswa muNew England Journal of Medicine (NEJM) [3]. Tsvagiridzo yavo inoratidza hungwaru hwekukunda kushomeka kwemaitiro ekuongorora kushanda kweCCIDID-19 antiviral mishonga mumakiriniki miedzo.

Iyi yekiriniki, yakanyoreswa paclinictrials.gov musi waNyamavhuvhu 8, 2021 (NCT05506176), ndiyo yekutanga inodzorwa neplacebo-chikamu chechitatu chekiriniki chemushonga wekuChina wekuvandudza anti-COVID-19. Muchikamu ichi 2-3 mapofu maviri, randomized, placebo-inodzorwa kuyedza, varwere vane hunyoro kusvika pakati nepakati COVID-19 mukati memazuva matatu ekutanga vakapihwa zvisina tsarukano 1: 1 kune yemuromo senotovir/ritonavir (750 mg/100 mg) kaviri pazuva kana placebo kwemazuva mashanu. Mhedzisiro yekutanga yekubudirira yaive nguva yekugadziriswa kwakasimba kweiyo 11 yakakosha zviratidzo, kureva kupora kwezviratidzo kwakagara kwemazuva maviri pasina kudzokororwa.

Kubva kuchinyorwa chino, tinogona kuwana magumo matsva e "11 core zviratidzo" zvechirwere chakapfava. Vaongorori havana kushandisa gumi nemana COVID-19 zviratidzo zveEPIC-SR kiriniki kuyedzwa, uye havana kushandisa huremu hwekufambisa seyekupedzisira.

Huwandu hwevarwere ve1208 vakanyoreswa, 603 vavo vakaiswa kuboka rekurapa senotevir uye 605 kuboka rekurapa placebo. Mhedzisiro yechidzidzo ichi yakaratidza kuti pakati pevarwere veMIT-1 vakawana kurapwa kwezvinodhaka mukati maawa makumi manomwe nemaviri ekutanga, nguva yekugadziriswa kwezviratidzo zveCCIDID-19 muboka re senotevir yaive ipfupi pane iyo muboka re placebo (180.1 maawa [95% CI, 162.1-201.6] vs. −35.8 maawa [95% CI, -60.1 kusvika -12.4]; Pazuva rechishanu rekunyora, kuderedzwa kwehutachiwana kubva pakutanga kwaive kwakakura muboka re senotevir pane boka re placebo (kureva musiyano [±SE], -1.51± 0.14 log10 makopi / ml; 95% CI, -1.79 kusvika -1.24). Pamusoro pezvo, mhedzisiro yechidzidzo mune ese echipiri endpoints uye subgroup ongororo yehuwandu yakaratidza kuti zenotevir inogona kupfupisa nguva yezviratidzo muCOVID-19 varwere. Mhedzisiro iyi inoratidza zvizere kuti Cenotevir ine pundutso yakakosha muchiratidzo ichi.

Chakanyanya kukosha nezvechidzidzo ichi ndechekuti chinotora nzira itsva yekuongorora kushanda kwayo. Isu tinogona kuona kubva pane zvakabatanidzwa kune bepa kuti vanyori vakapa nguva yakati wandei kuratidza kuvimbika kweiyi mhedzisiro yekupedzisira, kusanganisira kuenderana kwezviyero zvakadzokororwa zve11 core zviratidzo, uye kubatana kwayo ne14 zviratidzo. Vanhu vari munjodzi, kunyanya avo vane zvirwere zvepazasi uye avo vakafuta, vanobatsirikana zvakanyanya kubva muchidzidzo ichi. Izvi zvinotsigira kuvimbika kwechidzidzo kubva kumakona mazhinji, uye zvinoratidzawo kuti Cenotevir yabva paukoshi hwetsvakiridzo kuenda pakukosha kwekiriniki. Kuburitswa kwezvakabuda muongororo iyi kunotitendera kuona kubudirira kwevatsvagiri veChinese kugadzirisa zvine hungwaru matambudziko anozivikanwa pasi rose. Nekuvandudzwa kwemishonga yeutsva munyika yedu, isu tichatarisana nedambudziko rakada kufanana rekiriniki yekugadzira iyo inoda kuputswa mune ramangwana.