Meta-analysis of randomized controlled clinical trials of Riamilovir efficacy in the etiotropic therapy of acute respiratory viral infection

The aim of the study was to carry out meta-analysis of randomized controlled trials in order to combine the results of clinical trials on Triazavirin^® (Riamilovir) efficacy in the etiotropic therapy of acute respiratory viral infection. Materials and methods. The studies included 435 patients with a confirmed diagnosis of acute respiratory viral infection or ARVI (with laboratory confirmed absence of influenza virus antigens). The research was carried out in 27 centers. In studies, patients were divided into 3 groups in a 1:1:1 ratio (a total of 145 people per group). Each study included a group taking 100 mg of the medication 5 times a day, a group taking 250 mg of the medication 3 times a day and a placebo 2 times a day, as well as a group taking a placebo 5 times a day. The analysis was carried out in accordance with the PRISMA principles regarding the quality of information presentation on the results of systematic reviews and meta-analyzes of works evaluating the effects of medical interventions. Results. The conducted meta-analysis showed that the use of Triazavirin^® (Riamilovir) has a statistically significantly effects on the severity of clinical symptoms in patients with ARVI. The performed meta-analysis confirmed reliable associations between the use of Triazavirin^® (Riamilovir) in both doses and the chance of a persistent improvement in clinical symptoms on the 5^th day of therapy. The meta-analysis also confirmed the statistical significance of the clinical effects of Riamilovir by such indicators as the area under the curve «point on the scale showing the severity of the condition in a patient with ARVI in relation to time», the proportion of patients with complete alleviation of all symptoms by the end of the 5th day from the start of therapy. Conclusion. The clinical trials proved that the use of Triazavirin^® (Riamilovir) is effective both in the initial and in the late stages of the disease, therefore, the drug can be used in the initial therapy of adult patients with respiratory diseases of viral etiology.

1. Omel'yanovskij V. V., Avksent'eva M. V., Sura M. V., Khachatryan G. R., Fedyaeva V. K. Metodicheskie rekomendatsii po otsenke kachestva statisticheskogo analiza v klinicheskikh issledovaniyakh (Utverzhdeny prikazom FGBU «TsEKKMP» Minzdrava Rossii ot «29» dekabrya 2017 g. № 181-od). Moskva: FGBU «TsEKKMP» Minzdrava Rossii», 2017. (in Russian)

2. Lazarevich I. L. Farmakologicheskie i nefarmakologicheskie metody lecheniya ORVI. Meditsinskij Sovet. 2015; 3: 78–83. (in Russian)

3. Artem'ev G.A., Bondarev V.P., Borisevich S.V. i dr. Triazavirin — protivovirusnyj preparat novogo pokoleniya. Ekaterinburg : Institut organicheskogo sinteza im. I.Ya. Postovskogo UrO RAN, 2016; 257. (in Russian)

4. Lazareva N.B., Zhuravleva M.V., Panteleeva L.R. ORVI: ratsional'naya farmakoterapiya s pozitsii klinicheskoj farmakologii. Meditsinskij Sovet. 2016; 4: 68–73. (in Russian)

5. Sologub T.V., Tokin I.I., Midikari A.S., Tsvetkov V.V. Sravnitel'naya effektivnost' i bezopasnost' primeneniya protivovirusnykh preparatov v terapii bol'nykh grippom. Infektsionnye Bolezni. 2017; 15 (3): 25–32. doi 10.20953/1729-9225-2017-3-25-32. (in Russian)

6. Page M. J., McKenzie J.E.. Bossuyt P.M. et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. PLoS Medicine. 2021; 18 (3)e1003583. doi: 10.1371/journal.pmed.1003583.

7. Lioznov D.A., Tokin I.I., Zubkova T.G., Sorokin P.V. Praktika primeneniya otechestvennogo protivovirusnogo preparata v etiotropnoj terapii ostroj respiratornoj virusnoj infektsii. Terapevticheskij Arkhiv. 2020; 92 (12): 160–164. doi: 10.26442/00403660.2020.12.200427. (in Russian)

8. Tokin I.I., Zubkova T.G., Drozdova Jyu.V., Lioznov D.A. Opyt etiotropnoj terapii ORVI otechestvennym protivovirusnym preparatom. Infektsionnye Bolezni. 2019; 17 (4): 13–17. doi: 10.20953/1729-9225-2019-4-13-17. (in Russian)

9. Higgins J.P.T. (ed.). Cochrane handbook for systematic reviews of interventions version 6.2 (updated February 2021) Available from www.cochrane-handbook.org. The Cochrane Collaboration, 2021. https://training.cochrane.org/handbook/current (accessed Jun. 13, 2021).

10. Review Manager (RevMan) [Computer program]. Version 5.4, 2020. Accessed: Jun. 13, 2021. [Online]. Available: https://training.cochrane.org/online-learning/core-software-cochrane-reviews/revman.

11. Tikhonova E.P., Kuz'mina T.Jyu., Indronova N.V. i dr. Izuchenie effektivnosti protivovirusnykh preparatov (umifenovira, triazavirina) v otnoshenii ostrykh respiratornykh virusnykh infektsij Kazanskij Meditsinskij Zhurnal. 2018; 99 (2): 215–223. doi 10.17816/KMJ2018-215. (in Russian)

12. Verevshchikov V.K., Shemyakina E.K., Sabitov A.U., Khamanova Jyu.B. Vozmozhnosti etiotropnoj terapii pri grippe i ORVI s uchetom sroka gospitalizatsii bol'nykh v statsionar i riska razvitiya vtorichnykh oslozhnenij. Antibiotiki i Khimioterapiya. 2019; 64 (3–4): 10–14. doi 10.24411/0235-2990-2019-100012. (in Russian)

13. Verevshchikov V.K., Shemyakina E.K., Sabitov A.U., Batskalevich N.A. Sovremennaya etiotropnaya terapiya grippa i ORVI u vzroslykh bol'nykh s otyagoshchennoj premorbidnoj patologiej. Antibiotiki i Khimioterapiya. 2018; 63 (7–8): 47–50. (in Russian)