WHO launches global trial of the most promising coronavirus treatments

A drug combo already used against HIV. A malaria treatment first tested during World War II. A new antiviral whose promise against Ebola last year. These are the most promising drugs poised to testing by the World Health Organisation (WHO) in attempt to tackle the Covid-19 contagion. The global test called Solidarity is poised to start this week with many thousands of patients in dozens of countries.

With around 15% of Covid-19 patients suffering from severe disease and hospitals being overwhelmed, treatments are desperately needed. So rather than coming up with compounds from scratch that may take years to develop and test, researchers and public health agencies are looking to re-purpose drugs already approved for other diseases and known to be largely safe. They’re also looking at unapproved drugs that have performed well in animal studies with the other two deadly coronaviruses, which cause severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS).

Scientists have suggested dozens of existing medicines for testing but WHO is focusing on what it says are the four most promising therapies: an experimental antiviral compound called remdesivir; the malaria medications chloroquine and hydroxychloroquine; a combination of two HIV drugs, lopinavir and ritonavir; and that same combination plus interferon-beta, an immune system messenger that can help cripple viruses.

Enrolling subjects in Solidarity seems to be easy. When a person with a confirmed case of Covid-19 is deemed eligible, the physician can enter the patient’s data into a WHO website, including any underlying condition that could change the course of the disease, such as diabetes or HIV infection. The participant has to sign an informed consent form that is scanned and sent to WHO electronically. After the physician states which drugs are available at his or her hospital, the website will randomize the patient to one of the drugs available or to the local standard care for Covid-19.

The design is not double-blind, the gold standard in medical research, so there could be placebo effects from patients knowing they received a candidate drug. But WHO says it had to balance scientific rigour against speed. The idea for Solidarity came up less than two weeks ago, and the agency hopes to have supporting documentation and data management centres set up in due time.

More on this subject: Coronavirus

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