Advancements in oral therapeutic drugs for treating SARS-CoV-2 infections:A comprehensive review  

新型冠状病毒感染口服治疗药物的研究进展

作　　者：Li Wang Meng Rui Jun Peng Yun Ling 王立;芮萌;彭军;凌云(河北燕达医院呼吸与危重症医学科,河北廊坊065201;河北燕达医院药学部,河北廊坊065201)

机构地区：[1]Department of Respiratory and Critical Care Medicine,Hebei Yanda Hospital,Langfang 065201,Hebei,China [2]Department of Pharmacy,Hebei Yanda Hospital,Langfang 065201,Hebei,China

出　　处：《Journal of Chinese Pharmaceutical Sciences》2024年第11期1082-1089,共8页中国药学（英文版）

摘　　要：SARS-CoV-2 has undergone five major transformations from its original strain,evolving through Alpha,Beta,Gamma,Delta,and now Omicron.The Omicron variant stands out for its high transmissibility,reduced severity,mild symptoms,and low mortality.Today,Omicron infections have become akin to common upper respiratory tract infections,underscoring the critical role of oral therapeutic drugs in clinical settings.These small-molecule oral antivirals are game-changers,effectively preventing mild and moderate cases from escalating to severe conditions and significantly reducing mortality among severe cases.They have emerged as the frontline defenders in the fight against SARS-CoV-2.Currently,eight oral antiviral drugs have been approved for use,including four 3CL protease inhibitors(nirmatrelvir/ritonavir,simnotrelvir/ritonavir,atilotrelvir/ritonavir,ensitrelvir,and leritrelvir),and three RNA polymerase inhibitors(molnupiravir,azvudine,and deuterium remdesivir).These medications are readily available and have ensured an uninterrupted clinical supply.With the establishment of a robust post-infection immune barrier and the widespread clinical use of oral antiviral drugs,the global threat posed by the COVID-19 pandemic has significantly diminished.The relentless march of scientific progress and medical innovation has turned the tide,making COVID-19 a manageable part of our lives.2019年疫情爆发以来,新冠病毒(SARS-CoV-2)从原始株依次经历了阿尔法(Alpha,α)、贝塔(Beta,β)、伽马(Gamma,γ)、德尔塔(Delta,δ)和奥密克戎(Omicron,ο)的5次大变异,其传播力和致病性发生了很大的变化。目前的Omicron变异株传染性变强,毒力变弱,几乎不侵害肺部,重症率和病死率比以前大大下降。SARS-CoV-2已经变异为一种常见的呼吸道病毒,新冠病毒感染演变为一个常见的呼吸道传染病,所以口服治疗药物的使用就显得尤为重要。口服小分子抗新冠病毒药不仅可以使轻中症患者不发展成重症,而且可以减低重症患者的死亡率,已经成为临床治疗新冠病毒感染的主力军。已有8款新冠口服药批准上市,其中5款为3CL蛋白酶抑制剂,分别为奈玛特韦/利托那韦片、先诺特韦/利托那韦片、阿泰特韦/利托那韦片、恩赛特韦片和来瑞特韦片;另外3款为RNA聚合酶抑制剂,分别为莫诺拉韦胶囊、阿兹夫定片和氘瑞米德韦片。已上市的口服治疗新冠病毒感染药物主要是3CL蛋白酶抑制剂和RNA聚合酶抑制剂,临床的药品供应得到了充分的保障。随着感染后群体免疫屏障的建立,加上口服小分子抗新冠病毒药的使用,全球的COVID-19疫情对人类社会已经不能构成严重威胁。

关 键 词：SARS-CoV-2 infections Omicron variants Oral therapeutic drugs Research progress 

分 类 号：R978.7[医药卫生—药品]