WHO launches global megatrial of the four most promising coronavirus treatments

[RandySF]

A drug combo already used against HIV. A malaria treatment first tested during World War II. A new antiviral whose promise against Ebola fizzled last year.

Could any of these drugs hold the key to saving COVID-19 patients from serious harm or death? On Friday, the World Health Organization (WHO) announced a large global trial, called SOLIDARITY, to find out if any can treat infections with the new coronavirus for the dangerous respiratory disease. It’s an unprecedented effort—an all-out, coordinated push to collect robust scientific data rapidly during a pandemic. The study, which could include many thousands of patients in dozens of countries, has been designed to be as simple as possible so that even hospitals overwhelmed by an onslaught of COVID-19 patients can participate.

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 repurpose 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).

Drugs that slow or kill the novel coronavirus, called SARS-CoV-2, could save the lives of severely ill patients but might also be given prophylactically, to protect health care workers and others at high risk of infection. Treatments may also reduce the time patients spend in intensive care units, freeing critical hospital beds.



https://www.sciencemag.org/news/2020/03/who-launches-global-megatrial-four-most-promising-coronavirus-treatments

[hlthe2b]

1. Some posted here that we're overreacting about potential harm from chloroquine/hydroxychloroquine

really need to inform themselves and that includes some of my medical colleagues who have "bought" the party line about its decades of safety and its potential:

The WHO scientific panel designing SOLIDARITY had originally decided to leave the duo out of the trial but had a change of heart at a meeting in Geneva on 13 March, because the drugs “received significant attention” in many countries, according to the report of a WHO working group that looked into the drugs’ potential. The widespread interested prompted “the need to examine emerging evidence to inform a decision on its potential role.”

The available data are thin. The drugs work by decreasing the acidity in endosomes, compartments inside cells that they use to ingest outside material and that some viruses can coopt to enter a cell. But the main entryway for SARS-Cov-2 is a different one, using its so-called spike protein to attach to a receptor on the surface of human cells. Studies in cell culture have suggested chloroquines have some activity against SARS-CoV-2, but the doses needed are usually high—and could cause serious toxicities.

https://www.sciencemag.org/news/2020/03/who-launches-global-megatrial-four-most-promising-coronavirus-treatments


Encouraging cell study results with chloroquines against two other viral diseases, dengue and chikungunya, didn’t pan out in people in randomized clinical trials. And non-human primates infected with chikungunya did worse when given chloroquine. “Researchers have tried this drug on virus after virus, and it never works out in humans. The dose needed is just too high,” says Susanne Herold, an expert on pulmonary infections at the University of Giessen, Germany.

Results from COVID-19 patients are murky. Chinese researchers who report treating more than 100 patients with chloroquine touted its benefits in a letter in BioScience, but the data underlying the claim have not been published. All in all, more than 20 COVID-19 studies in China used chloroquine or hydroxychloroquine, WHO notes, but their results have been hard to come by. “WHO is engaging with Chinese colleagues at the mission in Geneva and have received assurances of improved collaboration; however, no data has been shared regarding the chloroquine studies.”

Hydroxychloroquine in particular might do more harm than good. The drug has a variety of side effects and can in rare cases harm the heart. Since people with heart conditions are at higher risk of severe COVID-19, that is a concern, says David Smith, an infectious disease physician at the University of California, San Diego. “This is a warning signal, but we still need to do the trial,” he says. What’s more, a rush to use the drug for COVID-19 might make it harder for the people who need it to treat their rheumatoid arthritis or malaria.

[Mike 03]

3. Experts are saying that French study was not even a good study. It was very small and

six people dropped out, some of them because they got worse.

[Drahthaardogs]

8. It was not terrible considering the time they had to do it

Chloroquine HAD been shown effective against SARs and MERs. It is a reasonable thought to think it has some efficacy here.

[magicarpet]

2. Thank you for locating and sharing this.

[magicarpet]

5. No one here is advocating that anyone...

.... frantically gulp down fists full of pills and medication from the shelves of your or someone elses medicine cabinet you know.

Until the vaccine comes out their are people with prior respiratory problems, who have asthma, who have COPD, and who customarily use hand held inhalers - who are in grave danger from COVID--19. If these folks get pneumonia, even though placed on a ventilator, they end up dead because they caught this virus.

Those are the people that need interim medications to tie them over until the vaccine comes out.

Glad to see the World Health Organization is alert to this fact and started the
mega global study (called Solidarity) to review the most promising medications already out there to help COVID-19 elderly patients on their death beds from this new virus.

[Mike 03]

4. The Remdesivir study looks like the most promising.

As for the Ritonavir/lopinavir studies, with or without interferon beta, I hope they give it early enough because it looks like giving it too late is almost worse than not giving it at all.

[magicarpet]

6. This,

[lostnfound]

7. Why not favipiravir / Avigan?

http://www.theguardian.com/world/2020/mar/18/japanese-flu-drug-clearly-effective-in-treating-coronavirus-says-china