Fighting the coronavirus: WHO launches global trial of most promising treatments

Currently, there is no existing specific treatment or vaccine to combat the new coronavirus. But could existing drugs crack the code?

On Friday, 20 March 2020, the World Health Organization (WHO) announced the Solidarity Trial – an aggressive effort across a number of countries to help combat coronavirus-related deaths.

The countries joining the trial are Thailand, Argentina, Bahrain, Canada, France, Iran, Norway, South Africa, Spain and Switzerland.

According to Daniel Kertesz, Thailand WHO representative, this global pandemic requires urgent global solutions and the goal of the trial is to help identify medicines that will save lives in the global battle to fight the virus.

Why are existing drugs being used?

Waiting for a successful vaccination to be developed could take several months. In the meantime, doctors around the world are trying to see which existing drugs could help.

Since the first cases of Covid-19, doctors have been treating the coronavirus with existing antivirals such a oseltamivir and lopinavir, or a combination of existing drugs, and research findings have been published in the International Journal of Infectious Diseases, according to a previous Health24 article.

"Drug repurposing is a strategy for generating additional value from an existing drug by targeting diseases other than that for which it was originally intended," said Denis Kainov, the senior author on the paper and an associate professor at the Norwegian University of Science and Technology (NTNU).

Drugs that slow or kill the Covid-19 virus, could potentially save the lives of numerous high-risk patients, but it can also be used in a preventative manner (prophylactically) to help protect health care workers and those who are likely to be high risk.

If treatments are successful, it may reduce time spent in hospital, which can free up beds and equipment in strained ICU units.

Which are the drugs on trial?

There are four existing drugs or combinations thereof that will be on trial:

1. Remdesivir

This drug was first used to treat cases of the Ebola and Marburg viruses, but it showed antiviral activity against RNA-viruses such as previous coronaviruses that caused the SARS and MERS outbreaks.

2. A combination of lopinavir and ritonavir

This combination is normally used to treat HIV. Also called protease inhibitors, they work by decreasing the amount of HIV in the blood. In the past, this combination was clinically tested to see what it would do in a case of SARS. It showed antiviral activity and fewer deaths. Experts are still divided on the outcome of this drug combo used for Covid-19, as this report shows.

3. Lopinavir/ritonavir combined with ribavirin and interferon beta

A previous study by the University of Hong Kong showed that a combination of these drugs could potentially expedite recovery, reduce mortality and suppress the viral load in Covid-19 virus cases. Research also showed efficacy against the coronavirus that caused the MERS outbreak.

4. Chloroquine

This drug was first used in the 1940s to treat malaria. The possibility of chloroquine being used to treat a different coronavirus, namely SARS, came up in a 2005 report published in the journal Virology. The study revealed that chloroquine could prevent the spread of the virus that caused the SARS outbreak in 2003.

According to reports, chloroquine interferes with the virus' ability to replicate in two ways – it alters the pH levels of the endosomes, compartments that the virus enters, and prevents the virus from plugging into the ACE2 receptors. 

While the drugs are generally well-tolerated, they can cause some side-effects.

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Image credit: iStock

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