Systemic review and meta-analysis of the three-component drug regimen (alpha-glutamyl-tryptophan, bendazole, ascorbic acid) prophylactic efficacy

Influenza and acute respiratory viral infections (ARVI) have a high prevalence, which determines their clinical and economic relevance. Agents activating nonspecific antiviral immunity mechanisms can be used to prevent these infections. Objective. To perform a systematic review and meta-analysis of the results of clinical studies on the preventive antiviral effectiveness of the three-drug regimen (alpha-glutamyl-tryptophan, bendazole, and ascorbic acid) against influenza and acute respiratory viral infections. Materials and methods. Following the PRISMA guidelines, the results of controlled clinical studies on the preventive effectiveness of the three-drug regimen (alpha-glutamyl-tryptophan, bendazole, and ascorbic acid) were selected using the recommended databases. The effectiveness was evaluated based on serum levels of total and stimulated interferon, serum and salivary immunoglobulin A levels, and oxidative and phagocytic activity of granulocytes and monocytes. The risk of bias and the quality of studies were assessed using the RoB 2 tool. The meta-analysis was conducted using the Meta package of the R statistical software and included an assessment of the generalized differences in the mean values of the parameters before and after the treatment course (Z-test), an assessment of the fixed/random weight of the studies, and verification of their heterogeneity (I2 test). Results. The results of four clinical studies, published between 2018 and 2021, were selected. A statistically significant (generalized) treatment effect size was identified for induced oxidative activity of granulocytes (an increase of 2.18 standard deviations; p=0.0004; I2=87.2%); salivary IgA levels (an increase of 0.73 standard deviations; p=0.0001; I2=86.6%); phagocytic activity of monocytes (an increase of 1.39 standard deviations; p=0.0001; I2=90.9%); phagocytic activity of granulocytes (an increase of 0.85 standard deviations; p=0.0031; I2=82.7%). Conclusion. The studied treatment regimen demonstrated an adaptive-activating effect on various elements of innate antigen-nonspecific immunity, contributing to the prevention of influenza and acute respiratory viral infections.