{"title":"<i>In Silico</i> Prediction of Andrographolide Dosage Regimens for COVID-19 Treatment.","authors":"Teerachat Saeheng, Juntra Karbwang, Kesara Na-Bangchang","doi":"10.1142/S0192415X22500732","DOIUrl":null,"url":null,"abstract":"<p><p>Andrographolide (APE) has been used for COVID-19 treatment in various clinical settings in South-East Asia due to its benefits on reduction of viral clearance and prevention of disease progression. However, the limitation of APE clinical use is the high incidence of adverse events. The objective of this study was to find the optimal dosage regimens of APE for COVID-19 treatment. The whole-body physiologically-based pharmacokinetic (PBPK) models were constructed using data from the published articles and validated against clinical observations. The inhibitory effect of APE was determined for the potency of drug efficacy. For prevention of pneumonia, multiple oral doses such as 120[Formula: see text]mg for three doses, followed by 60[Formula: see text]mg three times daily for 4 consecutive days, or 200[Formula: see text]mg intravenous infusion at the rate of 20 mg/h once daily is advised in patients with mild COVID-19. For prevention of pneumonia and reduction of viral clearance time, the recommended dosage regimen is 500[Formula: see text]mg intravenous infusion at the rate of 25[Formula: see text]mg/h once daily in patients with mild-to-moderate COVID-19. One hundred virtual populations (50 males and 50 females) were simulated for oral and intravenous infusion formulations of APE. The eligible PBPK/PD models successfully predicted optimal dosage regimens and formulations of APE for prevention of disease progression and/or reduction of viral clearance time. Additionally, APE should be co-administered with other antiviral drugs to enhance therapeutic efficacy for COVID-19 treatment.</p>","PeriodicalId":50814,"journal":{"name":"American Journal of Chinese Medicine","volume":null,"pages":null},"PeriodicalIF":4.8000,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Chinese Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1142/S0192415X22500732","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/8/27 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"INTEGRATIVE & COMPLEMENTARY MEDICINE","Score":null,"Total":0}
引用次数: 0
Abstract
Andrographolide (APE) has been used for COVID-19 treatment in various clinical settings in South-East Asia due to its benefits on reduction of viral clearance and prevention of disease progression. However, the limitation of APE clinical use is the high incidence of adverse events. The objective of this study was to find the optimal dosage regimens of APE for COVID-19 treatment. The whole-body physiologically-based pharmacokinetic (PBPK) models were constructed using data from the published articles and validated against clinical observations. The inhibitory effect of APE was determined for the potency of drug efficacy. For prevention of pneumonia, multiple oral doses such as 120[Formula: see text]mg for three doses, followed by 60[Formula: see text]mg three times daily for 4 consecutive days, or 200[Formula: see text]mg intravenous infusion at the rate of 20 mg/h once daily is advised in patients with mild COVID-19. For prevention of pneumonia and reduction of viral clearance time, the recommended dosage regimen is 500[Formula: see text]mg intravenous infusion at the rate of 25[Formula: see text]mg/h once daily in patients with mild-to-moderate COVID-19. One hundred virtual populations (50 males and 50 females) were simulated for oral and intravenous infusion formulations of APE. The eligible PBPK/PD models successfully predicted optimal dosage regimens and formulations of APE for prevention of disease progression and/or reduction of viral clearance time. Additionally, APE should be co-administered with other antiviral drugs to enhance therapeutic efficacy for COVID-19 treatment.
期刊介绍:
The American Journal of Chinese Medicine, which is defined in its broadest sense possible, publishes original articles and essays relating to traditional or ethnomedicine of all cultures. Areas of particular interest include:
Basic scientific and clinical research in indigenous medical techniques, therapeutic procedures, medicinal plants, and traditional medical theories and concepts;
Multidisciplinary study of medical practice and health care, especially from historical, cultural, public health, and socioeconomic perspectives;
International policy implications of comparative studies of medicine in all cultures, including such issues as health in developing countries, affordability and transferability of health-care techniques and concepts;
Translating scholarly ancient texts or modern publications on ethnomedicine.
The American Journal of Chinese Medicine will consider for publication a broad range of scholarly contributions, including original scientific research papers, review articles, editorial comments, social policy statements, brief news items, bibliographies, research guides, letters to the editors, book reviews, and selected reprints.