The World Health Organisation (WHO) has launched a multinational trial on a variety of repurposed drugs in the search for a treatment for Covid-19.
Clinical trials for the drugs will be undertaken in several countries to find potential therapies. The four drugs or combinations to be tested are antiviral drug remdesivir; a combination of HIV drugs lopinavir and ritonavir; a combination of lopinavir and ritonavir plus interferon-beta; and the antimalarial drug chloroquine.
The drugs have all shown some evidence of being effective against the virus that causes Covid-19, either in the lab and/or animal studies.
They will be compared to what is called standard of care — the regular support hospitals treating these patients use now such as supplementary oxygen when needed.
Remdesivir is made by Gilead. Lopinavir and ritonavir are combined and sold as Kaletra or Aluvia by AbbVie.
The trial, termed SOLIDARITY, will be carried out in 10 countries, with South Africa the only African country. The others are Argentina, Bahrain, Canada, France, Iran, Norway, Spain, Switzerland and Thailand.
“Multiple small trials with different methodologies may not give us the clear, strong evidence we need about which treatments help to save lives,” said WHO Director-General Tedros Adhanom Ghebreyesus during a press briefing in Geneva, Switzerland, on Wednesday.
In the three months that the novel coronavirus has grown from a regional crisis to a global pandemic, pharmaceutical companies have scrambled to advance their best ideas to stop it.
Some are taking a cue from older antivirals. Some are tapping tried-and-true technologies, and others are taking futuristic approaches to human medicine.
WHO is sponsoring and leading the coordination of this multi-arm, multi-country research. The Covid-19 Solidarity Response Fund has raised more than $43 million (Sh4.5 billion) from more than 173,000 individuals and organisations. Fifa has contributed $10 million (about Sh1.1 billion), Dr Ghebreyesus added.
Ana Maria Henao-Restrepo, WHO’s research and development “blueprint” group head, said the trial design was deliberately kept simple “to enable even hospitals that have been overloaded to participate”.
“This trial focuses on the key priority questions for the public. Do any of these drugs reduce mortality? Do any of these drugs reduce the time a patient is in hospital and whether or not the patients receiving any of the drugs needed ventilation or intensive care units,” Dr Henao-Restrepo said.
She added that chloroquine — which is cheap and used regularly around the world — will be tested in two ways. Some countries will test chloroquine against the standard of care while others will test hydroxychloroquine, which is used in parts of the world where malaria is resistant to chloroquine.
“The good thing about the trial is … that the randomisation could be adjusted to the drugs available in each individual hospital over time. The other good thing … is that we can include additional arms or drop arms as our global data safety and monitoring committee advises we should do,” she said.