95% of researchers rate our articles as excellent or good
Learn more about the work of our research integrity team to safeguard the quality of each article we publish.
Find out more
REVIEW article
Front. Pharmacol.
Sec. Pharmacology of Infectious Diseases
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1524072
Advances in the Effectiveness and Safety of Azvudine Treatment: A Comprehensive Review
Provisionally accepted
Jiayi Li 1,2 Bo Zhu 1,3 Jian Lu 1
Zheyi Dong 4
Ping Li 4
Wenge Li 1*
Chunfu Zheng 5*
Biao Jun Chang 3*
Shunlai Shang 1*- 1 China-Japan Friendship Hospital, Beijing, China
- 2 Health Science Centre, Peking University, Beijing, Beijing Municipality, China
- 3 Pingyuan Labrarory, Xinxiang, China
- 4 First Affiliated Hospital of Chinese PLA General Hospital, Beijing, Beijing Municipality, China
- 5 University of Calgary, Calgary, Alberta, Canada
The global impact of COVID-19 has highlighted the urgent need for effective therapeutic interventions against SARS-CoV-2. Azvudine, a dual-target nucleoside drug initially developed for human immunodeficiency virus (HIV), has gained attention for its potential in treating COVID-19. On July 25, 2022, Azvudine received conditional approval from the National Medical Products Administration (NMPA) of China, making it the first oral SARS-CoV-2 RNA-dependent RNA polymerase (RdRp) inhibitor for COVID-19 treatment. This review explores the pharmacological activity, antiviral mechanisms, and clinical effectiveness of azvudine in the context of COVID-19. Clinical trials have demonstrated its ability to reduce the viral load, shorten the time to nucleic acid negativity, and improve clinical outcomes in patients. Additionally, azvudine has shown excellent pharmacokinetic properties and a favorable safety profile with mild side effects. The review also addresses the importance of drug interactions and safety considerations, particularly in high-risk populations. Research should focus on optimizing second-generation inhibitors with enhanced effectiveness against SARS-CoV-2 variants, improving oral bioavailability, and minimizing adverse effects, ensuring more robust treatment options for COVID-19.
Keywords: azvudine, COVID-19, SARS-CoV-2 RdRp, pharmacokinetics, Special patients
Received: 07 Nov 2024; Accepted: 01 Apr 2025.
Copyright: © 2025 Li, Zhu, Lu, Dong, Li, Li, Zheng, Chang and Shang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Wenge Li, China-Japan Friendship Hospital, Beijing, China
Chunfu Zheng, University of Calgary, Calgary, T2N 1N4, Alberta, Canada
Biao Jun Chang, Pingyuan Labrarory, Xinxiang, China
Shunlai Shang, China-Japan Friendship Hospital, Beijing, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.