Lopinavir-ritonavir not effective against Covid-19, says Department of Health

While there is no vaccine to protect against the new coronavirus, scientists and medical experts are buying time by looking at the effects of existing drugs.

Lopinavir-ritonavir (LPV/r) is a combination of antivirals used to treat HIV.

Why this HIV drug?

The possibility of using this drug combination to treat Covid-19 started when the World Health Organization (WHO) announced their Solidarity trial – a collaboration between different countries, where four existing drugs would be trialled to determine their effect on Covid-19 patients.

One of these drugs is the lopinavir-ritonavir combination. While there was no certainty that it would be effective in Covid-19 patients, there were some positive indications from laboratory experiments, according to the WHO.

Now, the South African Department of Health conducted a rapid review of available published clinical evidence and found it doubtful whether the lopinavir-ritonavir combination could be a viable treatment option.

What the Department found

According to a press statement, the Department of Health did a search on 11 April 2020 on two electronic databases (Epistemonikos and PubMed) to review existing evidence of the clinical effects of lopinavir-ritonavir.

They also searched for any pre-printed studies on medrxiv.org to find evidence.

In their search, they looked at 64 records of research, including two trials that were conducted in China. One trial included severe Covid-19 cases, while the other trial focused on mild to moderate cases. 

They came to the conclusion that there is not sufficient evidence to indicate that lopinavir-ritonavir is an effective treatment for Covid-19. While it posed no serious side effects in patients, it was linked to an increase in non-serious gastrointestinal side-effects.

Based on their review of current, existing data, lopinavir-ritonavir is not recommended as a treatment for Covid-19.

Another study deemed drug not effective

Research, published in the journal Med, also showed in a randomised, controlled study that the drug didn’t improve the outcome of mild to moderate Covid-19 patients.

"We found that neither lopinavir-ritonavir nor Arbidol could benefit clinical outcomes for patients and that they might bring some side effects," says co-senior author Linghua Li, Vice Director of the Centre for Infectious Diseases of Guangzhou Eighth People's Hospital in Guangzhou, China, in a news release

Warning against using unproven medication

While there is currently no targeted treatment for Covid-19, doctors are treating cases based on their specific symptoms.

But the national drug regulator warned that some doctors are prescribing unproven treatments, including chloroquine, a malaria drug that received a massive amount of press for its supposed benefits against Covid-19.

Unregulated and arbitrary prescription of this medication is not only not yet backed by science, it’s also a missed opportunity to gain information on possible coronavirus treatments in a way that could be useful for future outbreaks, according to a previous article in Health24.

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