Clinical Trial News: Drug Combo Tested in Severe COVID-19
Various news outlets around the world have reported on apparent clinical trials testing the efficacy of anti-HIV (human immunodeficiency viruses) medication in combatting COVID-19.
Classed as severe acute respiratory syndrome coronavirus-2, or SARS-CoV-2, the novel coronavirus was first detected in Wuhan, China. The virus spread rapidly across the globe, causing numerous epidemic clusters and forcing the World Health Organisation (WHO) to officially announce the COVID-19 pandemic. Now, a new clinical trial has found no significant benefits in treating severe cases of the disease with anti-HIV drugs.
At the time of writing, 76,551 people have died from COVID-19 and over 1.3 million cases have been confirmed worldwide. The lethality of the disease is largely attributed to the lack of specific antivirals suitable for treating it. Most individuals who contract COVID-19 experience respiratory illness, but some cases intensify and result in organ failure, pneumonia, and death.
In the absence of an effective COVID-19 treatment, many countries have opted to enforce social distancing measures to limit the spread of the disease. This is a key step to reducing pressure on healthcare systems while ongoing clinical trials look for effective treatments.
Anti-HIV Medication & Coronaviruses
A new study titled “A Trial of Lopinavir—Ritonavir in Adults Hospitalized with Severe COVID-19” was recently published in the New England Journal of Medicine (NEJM). Researchers from China and the UK collaborated on the clinical trial, which was named LOTUS China, an abbreviation of Lopinavir Trial for Suppression of SARS-Cov2 in China.
The clinical trial involved oral administration of a combination of lopinavir and ritonavir – two specific anti-HIV medicines – to adult patients who had been admitted to Jin Yin-Tan Hospital, Wuhan hospital with severe COVID-19.
The historical precedent for treating novel coronavirus with anti-HIV drugs was set in 2003, when lopinavir was used to treat SARS and Middle-East respiratory syndrome coronavirus (MERS-Cov). In this latest clinical trial, ritonavir was used to supplement lopinavir and increase the duration of action. However, the randomized control trial study found no difference in time to clinical improvement between a population who received standard care and those who received the anti-HIV drug combination. Risk of death was estimated at a similar level between both groups, and, though the percentage of clinical improvement for those on the novel treatment was greater by a factor of 15.5%, researchers determined that any such benefits were negligible, concluding:
“Future trials in patients with severe illness may help to confirm or exclude the possibility of a treatment benefit”.
Clinical Trial News with Matrix Healthcare Solutions (MHS)
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A Trial of Lopinavir–Ritonavir in Adults Hospitalized with Severe Covid-19, Bin Cao, M.D., Yeming Wang, M.D., Danning Wen, M.D., Wen Liu, M.S., Jingli Wang, M.D., Guohui Fan, M.S., Lianguo Ruan, M.D., Bin Song, M.D., Yanping Cai, M.D., Ming Wei, M.D., Xingwang Li, M.D., Jiaan Xia, M.D., et al. NEJM, March 18, 2020, DOI: 10.1056/NEJMoa2001282, https://www.nejm.org/doi/full/10.1056/NEJMoa2001282