Review Penggunaan Antivirus COVID-19 Berdasarkan Pedoman Penatalaksanaan COVID-19 pada Periode Maret 2020-Agustus 2021

Rogayah Effendy, Auliya Suwantika, Cherry Rahayu

Abstract


Pandemi Coronavirus disease 2019 (COVID-19) telah menjadi tantangan kesehatan utama dunia hingga saat ini. Belum adanya antivirus spesifik yang terbukti efektif telah menimbulkan dampak negatif ekonomi yang cukup signifikan. Salah satu strategi terapeutik difokuskan pada tindakan pencegahan dan pengendalian infeksi, yaitu dengan penggunaan antivirus. Review ini difokuskan pada studi deskriptif-komparatif penggunaan antivirus dengan tingkat keparahan tertentu dan potensi pengaruh penggunaannya terhadap efektivitas biaya berbasis pedoman/protokol COVID-19 di Indonesia. Penggunaan antivirus untuk tiap pasien diidentifikasi sesuai tingkat keparahan penyakit dan dibandingkan antar pedoman berdasarkan perspektif pemerintah. Hasilnya menyoroti pada tantangan besar perkembangan studi antivirus yang dinamis karena situasi pandemi serta perlunya intervensi pemerintah untuk menentukan intervensi prioritas dengan keterbatasan personel serta sumber daya ekonomi (priority setting). Review memberikan analisis terperinci ditinjau dari protokol tata klinis COVID-19, antara bulan Maret 2020 hingga Agustus 2021. Hasilnya menyoroti strategi penanggulangan pemerintah dalam tata klinis antivirus yang optimal dan efektif serta potensi biaya yang ditimbulkannya. Pedoman pengendalian dan tata laksana antivirus COVID-19 di Indonesia, sudah berganti sebanyak 4 kali, priority setting dilakukan berdasarkan perkembangan studi terbaru di masa pandemi dan sudah berbasis bukti terkini yang sifatnya masih terbatas namun dengan tingkat bukti tinggi. Penghematan biaya dapat dilakukan dengan deteksi dini dan pengobatan efektif pada  kasus COVID-19, sebelum terjadi perburukan ke tingkat keparahan berikutnya. Efektivitas pengobatan dan penggunaan antivirus berbasis bukti dapat membuat terapi menjadi cost-effective. Oleh karena itu, pembuat kebijakan di Indonesia harus mengintensifkan deteksi dini dan manajemen kasus COVID-19 sebagai prioritas utama, dengan penggunaan antivirus berdasarkan rekomendasi WHO yang senantiasa dinamis mengikuti perkembangan terkini.


Keywords


Antivirus, cost-effective, Indonesia, pedoman, priority setting

References


Dhama K, Khan S, Tiwari R, Sircar S, Bhat S, Malik YS, Update on COVID-19, 10-2020. Clin Microbiol Rev. 2020;33(4):1-48. doi: 10.1128/CMR.00028-20

Mohapatra RK, Mishra S, Azam M, Dhama K. COVID-19, WHO guidelines, pedagogy, and respite. Open Med. 2021;16(1):491-493. doi:10.1515/med-2021-0266

World Health Organization. WHO Coronavirus (COVID-19) Dashboard [diunduh 27 Desember 2021]. Tersedia dari: https://covid19.who.int/

Schellekens P, Sourrouille D. COVID-19 mortality in rich and poor countries a tale of two pandemics [diunduh 29 Desember 2021]. Tersedia dari: https://documents1.worldbank.org/curated/en/559181590712052524

Jin H, Wang H, Li X, Zheng W, Ye S, Zhang S, et al. Economic burden of COVID-19, China, January-March, 2020: a cost-of-illness study. Bull World Heal Organ. 2021;(99):122-124.

Kementrian Keuangan Republik Indonesia. Biaya Penanganan COVID-19 [diunduh 29 Desember 2021]. Tersedia dari: https://www.kemenkeu.go.id/media/15368

Lin SN, Rui J, Chen QP, Zhao B, Yu SS, Li ZY, et al. Effectiveness of potential antiviral treatments in COVID-19 transmission control: a modelling study. Infect Dis Poverty. 2021;10(1):1-17. doi:10.1186/s40249-021-00835-2

Djaafara BA, Whittaker C, Watson OJ, Verity R, Brazeau NF, Widyastuti W, et al. Quantifying the dynamics of COVID-19 burden and impact of interventions in Java, Indonesia. medRxiv. 2020;2020(September):2020.10.02.20198663. https://doi.org/10.1101/2020.10.02.20198663

Kementerian Kesehatan Republik Indonesia. Keputusan Menteri Kesehatan Republik Indonesia Nomor HK.01.07/MENKES/247 Tahun 2020 tentang Pedoman Pencegahan dan Pengendalian Corona Virus Disease 2019 (COVID-19). Jakarta: Kementerian Kesehatan Republik Indonesia; 2020.

Frediansyah A, Tiwari R, Sharun K, Dhama K, Harapan H. Antivirals for COVID-19: A critical review. Clin Epidemiol Glob Heal. 2021;9(July 2020):90-98. doi:10.1016/j.cegh.2020.07.006

Okoli GN, Rabbani R, Al-Juboori A, Copstein L, Askin N, Abou-Setta AM. Antiviral drugs for coronavirus disease 2019 (COVID-19): a systematic review with network meta-analysis. Expert Rev Anti Infect Ther. 2022;20(2):267-278. doi:10.1080/14787210.2021.1961579

Badan Pengawas Obat dan Makanan Republik Indonesia. Keputusan Kepala Badan Pengawas Obat dan Makanan Republik Indonesia Nomor HK 02.02.1.2.03.20.134 Tahun 2020 Tentang Penetapan Pedoman Obat dalam Penanganan Corona Virus Disease 2019 (COVID-19). Jakarta: Badan Pengawas Obat dan Makanan; 2020.

Instiaty, Sri Darmayani IGAAP, Marzuki JE, Angelia F, William, Siane A, et al. Antiviral treatment of COVID-19: A clinical pharmacology narrative review. Med J Indones. 2020;29(3):332-345. doi:10.13181/mji.rev.204652

Kementerian Kesehatan Republik Indonesia. Keputusan Menteri Kesehatan Republik Indonesia Nomor HK.01.07/MENKES/413 Tahun 2020 tentang Pedoman Pencegahan dan Pengendalian Corona Virus Disease 2019 (COVID-19). Jakarta: Kementerian Kesehatan Republik Indonesia; 2020

Perhimpunan Dokter Paru Indonesia (PDPI), Perhimpunan Dokter Spesialis Kardiovaskuler Indonesia (PERKI), Perhimpunan Dokter Spesialis Penyakit Dalam Indonesia (PAPDI), Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif Indonesia (PERDATIN), Ikatan Dokter Anak Indonesia (IDAI). Pedoman Tatalaksana COVID-19 Edisi ke-2. Agustus 2020. Jakarta; 2020.

Perhimpunan Dokter Paru Indonesia (PDPI), Perhimpunan Dokter Spesialis Kardiovaskuler Indonesia (PERKI), Perhimpunan Dokter Spesialis Penyakit Dalam Indonesia (PAPDI), Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif Indonesia (PERDATIN), Ikatan Dokter Anak Indonesia (IDAI). Pedoman Tatalaksana COVID-19 Edisi ke-3. Desember 2020. Jakarta; 2020.

Kementerian Kesehatan Republik Indonesia. Keputusan Menteri Kesehatan Republik Indonesia Nomor HK.01.07/MENKES/5671 Tahun 2021 tentang Manajemen Klinis Tata Laksana Corona Virus Disease 2019 (COVID-19) di Fasilitas Pelayanan Kesehatan. Jakarta: Kementerian Kesehatan Republik Indonesia; 2021.

Jeck J, Jakobs F, Kron A, Franz J, Cornely OA, Kron F. A cost of illness study of COVID-19 patients and retrospective modelling of potential cost savings when administering remdesivir during the pandemic “first wave” in a German tertiary care hospital. Infection. 2022;50(1):191-201. doi:10.1007/s15010-021-01685-8

WHO Solidarity Trial Consortium: Pan H, Peto R, Restrepo AM, Preziosi MP, SathiyamoorthyV, et al, Repurposed Antiviral Drugs for Covid-19 — Interim WHO Solidarity Trial Results. N Engl J Med. 2021;384(6):497-511. doi:10.1056/nejmoa2023184

Liu W, Zhou P, Chen K, Ye Z, Liu F, Li X, et al. Efficacy and safety of antiviral treatment for COVID-19 from evidence in studies of SARS-CoV-2 and other acute viral infections: a systematic review and meta-analysis. Can Med Assoc J. 2020;192(27):E734-E744. doi:10.1503/cmaj.200647

Hong YN, Xu J, Sasa GBK, Zhou KX, Ding XF. Remdesivir as a broad-spectrum antiviral drug against COVID-19. Eur Rev Med Pharmacol Sci. 2021;25(1):541-548. doi:10.26355/eurrev_202101_24426

Beigel JH, Tomashek KM, Dodd LE, Mehta AK, Zingman BS, Kalil AC, et al. Remdesivir for the Treatment of Covid-19 — Final Report. N Engl J Med. 2020;383(19):1813-1826. doi:10.1056/nejmoa2007764

Goldman JD, Lye DCB, Hui DS, Marks KM, Bruno R, Montejano R, et al. Remdesivir for 5 or 10 Days in Patients with Severe Covid-19. N Engl J Med. 2020;383(19):1827-1837. doi:10.1056/nejmoa2015301

Dawoud DM, Soliman KY. Cost-Effectiveness of Antiviral Treatments for Pandemics and Outbreaks of Respiratory Illnesses, Including COVID-19: A Systematic Review of Published Economic Evaluations. Orphanet J Rare Dis. 2020;23(11):1409-1422. doi:10.1016/j.jval.2020.07.002

Qomara WF, Primanissa DN, Amalia SH, Purwadi F V., Zakiyah N. Effectiveness of remdesivir, lopinavir/ritonavir, and favipiravir for COVID-19 treatment: A systematic review. Int J Gen Med. 2021;14(August):8557-8571. doi:10.2147/IJGM.S332458

WHO R&D Blueprint: COVID-19 Experimental Treatments [diunduh 29 Desember 2021]. Tersedia dari: https://www.who.int/teams/blueprint/covid-19.

Amani B, Khanijahani A, Amani B, Hashemi P. Lopinavir / Ritonavir for COVID-19 : a Systematic Review and Meta-Analysis. J Pharm Pharm Sci. 2021;24:246-257. doi: 10.18433/jpps31668.

Cao B, Wang Y, Wen D, Liu W, Wang J, Fan G, et al. A Trial of Lopinavir–Ritonavir in Adults Hospitalized with Severe COVID-19. N Engl J Med. 2020;382(19):1787-1799. doi:10.1056/nejmoa2001282

Sur M, Lopez MJ, Baker MB. Oseltamivir. [diunduh 12 Desember 2021]. Tersedia dari: https://pubmed.ncbi.nlm.nih.gov/30969731/

Tan Q, Duan L, Ma Y, Wu F, Huang Q, Mao Kn et al. Is oseltamivir suitable for fighting against COVID-19 : In silico assessment , in vitro and retrospective study. Bioorganic Chemistry; 2020;(January) 104527.

Chiba S. Effect of Early Oseltamivir on COVID-19-Suspected Outpatients without Hypoxia.; The Central European Journal of Medicine, 2020. doi:10.21203/rs.3.rs-33046/v1

Agrawal U, Raju R, Udwadia ZF. Favipiravir: A new and emerging antiviral option in COVID-19. Med J Armed Forces India. 2020;76(4):370-376. doi:10.1016/j.mjafi.2020.08.004

Ivashchenko AA, Dmitriev KA, Vostokova N V, Azarova VN, Blinow AA, Egorova AN, et al. AVIFAVIR for Treatment of Patients With Moderate Coronavirus Disease 2019 (COVID-19): Interim Results of a Phase II/III Multicenter Randomized Clinical Trial. Clin Infect Dis. 2021;73(3):531-534. doi:10.1093/cid/ciaa1176

Udwadia ZF, Singh P, Barkate H, Patil S, Rangwala S, Pendse A et al. Efficacy and safety of favipiravir, an oral RNA-dependent RNA polymerase inhibitor, in mild-to-moderate COVID-19: A randomized, comparative, open-label, multicenter, phase 3 clinical trial. Int J Infect Dis. 2021;103:62-71. doi:10.1016/j.ijid.2020.11.142

Dabbous HM, Elsalam S, Elsayed MH, Sherief AH, Ebeid FF, Elgafar MS, et al, Efficacy of favipiravir in COVID-19 treatment: a multi-center randomized study. Arch Virol. 2021;Jan 25: 1-6. doi:10.1007/s00705-021-04956-9.

Hassanipour S, Arab-Zozani M, Amani B, Heidarzad F, Fathalipour M, Martinez-de-Hoyo R. The efficacy and safety of Favipiravir in treatment of COVID-19: a systematic review and meta-analysis of clinical trials. Sci Rep. 2021;11(1):1-11. doi:10.1038/s41598-021-90551-6

Oktarini R, Rahmasari R, Sauriasari R. Safety of Favipiravir for Treatment of COVID-19 : Latest Systematic Review Keamanan Favipiravir untuk Terapi COVID-19 : Tinjauan Sistematis Terbaru. 2022;42(1).70-79 doi:10.36497/jri.v42i1.243

Rochwerg B, Agoritsas T, Lamontagne F, et al. A living WHO guideline on drugs for covid-19. BMJ. 2020;370:m3379. doi:10.1136/bmj.m3379

Gordon CJ, Tchesnokov EP, Woolner E, et al. Remdesivir is a direct-acting antiviral that inhibits RNA-dependent RNA polymerase from severe acute respiratory syndrome coronavirus 2 with high potency. J Biol Chem. 2020;295(20):6785-6797. doi:10.1074/jbc.RA120.013679

Al-abdouh A, Bizanti A, Barbarawi M, Jabri A, Kumar A. Remdesivir for the treatment of COVID-19: A systematic review and meta-analysis of randomized controlled trials. Contemp Clin Trials 101. 2021;106272(January).

Jiang Y, Chen D, Cai D, Yi Y, Jiang S. Effectiveness of remdesivir for the treatment of hospitalized COVID-19 persons: A network meta-analysis. J Med Virol. 2021;93(2):1171-1174. doi:10.1002/jmv.26443

Singh S, Khera D, Chugh A, Khera PS, Chugh VK. Efficacy and safety of remdesivir in COVID-19 caused by SARS-CoV-2: A systematic review and meta-analysis. BMJ Open. 2021;11(6). doi:10.1136/bmjopen-2020-048416

Shrestha DB, Budhathoki P, Syed N i. H, Rawal E, Raut S, Khadka S. Remdesivir: A potential game-changer or just a myth? A systematic review and meta-analysis. Life Sci. 2021;264(October 2020):118663. doi:10.1016/j.lfs.2020.118663

Rezagholizadeh A, Khiali S, Sarbakhsh P, Entezari-Maleki T. Remdesivir for treatment of COVID-19; an updated systematic review and meta-analysis. Eur J Pharmacol. 2021;897(173926).

Lukito JI. Tinjauan Antivirus untuk Terapi COVID-19. 2020;47(5):340-345.

Varghese G, John R, Manesh A, Karthik R, Abraham O. Clinical management of COVID-19. Indian J Med Res. Published online 2020. doi:10.4103/ijmr.IJMR_957_20

Eastman RT, Roth JS, Brimacombe KR, Simeonov A, Shen M, Patnaik S, et al. Remdesivir: A Review of Its Discovery and Development Leading to Emergency Use Authorization for Treatment of COVID-19. ACS Cent Sci. 2020;6(5):672-683. doi:10.1021/acscentsci.0c00489

Institute for Clinical and Economic Review. ICER Provides First Update to Pricing Models for Remdesivir as a Treatment for COVID-19 [diunduh 10 September 2021]. Tersedia dari: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7347759/

Choi JY, Smith DM. SARS-CoV-2 variants of concern. Yonsei Med J. 2021;62(11):961-968. doi:10.3349/ymj.2021.62.11.961

Murayama H, Kayano T, Nishiura H. Estimating COVID-19 cases infected with the variant alpha (VOC 202012/01): an analysis of screening data in Tokyo, January-March 2021. Theor Biol Med Model. 2021;18(1):1-5. doi:10.1186/s12976-021-00146-x

Kumar S, Thambiraja TS, Karuppanan K, Subramaniam G. Omicron and Delta variant of SARS-CoV-2: A comparative computational study of spike protein. J Med Virol. 2022;94(4):1641-1649. doi:10.1002/jmv.27526




DOI: https://doi.org/10.15416/ijcp.2022.11.3.267

Refbacks

  • There are currently no refbacks.


 Indonesian Journal of Clinical Pharmacy is indexed by

        

  Creative Commons License

IJCP by Universitas Padjadjaran is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License

 

View My Stats