495 KB53 KB200520252020Knez, LeaLocatelli, IgorMorgan, TinaTomšič, Tanjaštevilka:2letnik:71str. 121-132ISSN:0014-8229COBISSID_HOST:21007107URN:URN:NBN:SI:doc-057JAY2RslSlovensko farmacevtsko društvoFarmacevtski vestnikcovid-19favipiravirhidroksiklorokinlopinavir/ritonavirPandemijeremdesivirZ dokazi podprto zdravljenje covid-19 z zdravili| Evidence based medicine for covid-19 treatment|In the siege for a drug for covid-19, early signals of drugs' effectiveness were magnified and the need to prove a drug as effective and safe in the frame of randomized clinical trials (RCT) was neglected. Herein the most prominent covid-19 treatments, remdesivir, loponavir/ritonavir, favipiravir and (hydroxy)chloroquine, are presented. Remdesivir, accessible in Slovenia within a compassionate use program, is highlighted as proved effective in shortening the time to clinical improvement in a large RCT with 1059 covid-19 patients, with no important safety signals. On the other hand, the broad use of (hydroxy)chloroquine despite the lacking evidence of effectiveness is discussed in the light of its possible detrimental effects as suggested by recent large observational studies. A further proof of the need for clinical trials, also in Slovenia, to upgrade from ''thinking'' to ''knowing'' drugs that are effective and safe in treating patients with covid-19V želji po zdravilu za zdravljenje covid-19 se tudi v strokovni javnosti razveselimo vsakega pozitivnega signala učinkovitosti in pozabljamo, da dokaz varnosti in učinkovitosti zdravil zahteva potrditev v randomiziranih kliničnih raziskavah. V prispevku opisujemo najbolj odmevna zdravila pri covid-19: remdesivir, lopinavir z ritonavirjem, favipiravir in (hidroksi)klorokin. Izpostavljamo predvsem remdesivir, ki je dostopen v okviru programa sočutne uporabe in ki je v randomizirani klinični raziskavi na 1059 bolnikih pokazal pomembno hitrejše klinično izboljšanje covid-19, brez pomembnih varnostnih signalov. Na drugi strani izpostavljamo pomanjkanje dokazov učinkovitosti (hidroksi)klorokina, ki smo ga začeli množično uporabljati po objavi predobrih izidov zdravljenja pri le 36 bolnikih, novejše velike opazovalne raziskave pa postavljajo celo sum o manj ugodnih izidih zdravljenja. To je le dokaz več, da se lahko le preko kliničnih raziskav, tudi v Sloveniji, premaknemo iz točke, ko ''mislimo'', k temu, da ''vemo'', katera zdravila so varna in učinkovita pri covid-19TEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaSlovensko farmacevtsko društvo