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Pharmacologic Treatments for Coronavirus Disease 2019 (COVID-19): A Review.
JAMA. 2020 May 12; 323(18):1824-1836.JAMA

Abstract

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.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Sanders JM
Department of Pharmacy, University of Texas Southwestern Medical Center, Dallas. Division of Infectious Diseases and Geographic Medicine, Department of Medicine, University of Texas Southwestern Medical Center, Dallas.
Monogue ML
Department of Pharmacy, University of Texas Southwestern Medical Center, Dallas. Division of Infectious Diseases and Geographic Medicine, Department of Medicine, University of Texas Southwestern Medical Center, Dallas.
Jodlowski TZ
Pharmacy Service, VA North Texas Health Care System, Dallas.
Cutrell JB
Division of Infectious Diseases and Geographic Medicine, Department of Medicine, University of Texas Southwestern Medical Center, Dallas.

MeSH

Adenosine MonophosphateAdrenal Cortex HormonesAlanineAmidesAngiotensin Receptor AntagonistsAngiotensin-Converting Enzyme InhibitorsAntiviral AgentsAzithromycinBetacoronavirusCOVID-19ChloroquineCoronavirus InfectionsHumansHydroxychloroquineImmunoglobulinsImmunologic FactorsIndolesLopinavirOseltamivirPandemicsPneumonia, ViralPyrazinesRibavirinRitonavirSARS-CoV-2Withholding TreatmentCOVID-19 Drug Treatment

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

32282022

Clinical Trial Links

The Use of Brazilian Green Propolis Extract (EPP-AF) in Patients Affected by COVID-19.

Citation

Sanders, James M., et al. "Pharmacologic Treatments for Coronavirus Disease 2019 (COVID-19): a Review." JAMA, vol. 323, no. 18, 2020, pp. 1824-1836.
Sanders JM, Monogue ML, Jodlowski TZ, et al. Pharmacologic Treatments for Coronavirus Disease 2019 (COVID-19): A Review. JAMA. 2020;323(18):1824-1836.
Sanders, J. M., Monogue, M. L., Jodlowski, T. Z., & Cutrell, J. B. (2020). Pharmacologic Treatments for Coronavirus Disease 2019 (COVID-19): A Review. JAMA, 323(18), 1824-1836. https://doi.org/10.1001/jama.2020.6019
Sanders JM, et al. Pharmacologic Treatments for Coronavirus Disease 2019 (COVID-19): a Review. JAMA. 2020 May 12;323(18):1824-1836. PubMed PMID: 32282022.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pharmacologic Treatments for Coronavirus Disease 2019 (COVID-19): A Review. AU - Sanders,James M, AU - Monogue,Marguerite L, AU - Jodlowski,Tomasz Z, AU - Cutrell,James B, PY - 2020/4/14/pubmed PY - 2020/9/24/medline PY - 2020/4/14/entrez SP - 1824 EP - 1836 JF - JAMA JO - JAMA VL - 323 IS - 18 N2 - 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. SN - 1538-3598 UR - https://www.unboundmedicine.com/medline/citation/32282022/Pharmacologic_Treatments_for_Coronavirus_Disease_2019__COVID_19_:_A_Review_ DB - PRIME DP - Unbound Medicine ER -