Repurposed Antiviral Drugs for Covid-19 — Interim WHO Solidarity Trial Results

Study (405 hospitals,30 countries, n=11,330 adults) found remdesivir, hydroxychloroquine, lopinavir, and interferon regimens had little or no effect on hospitalized patients with Covid-19, as indicated by overall mortality, initiation of ventilation, and duration of hospital stay

SPS commentary:

In the study, 2750 patients were assigned to receive remdesivir, 954 to hydroxychloroquine, 1411 to lopinavir (without interferon), 2063 to interferon (including 651 to interferon plus lopinavir), and 4088 to no trial drug.

An editorial notes that viewed collectively with previous studies, the Solidarity trial sends the clear message that these drugs as currently used should no longer be considered viable treatment options for Covid-19. It notes however that the case for the continued use of remdesivir is more nuanced; other data suggest that it may still have an important role. It adds the benefit with remdesivir may be its ability to change the course of hospitalisation in some patients, but the results of the Solidarity trial indicates that substantially reduced mortality in not expected.

It discusses the next set of questions regarding remdesivir that can be answered only in placebo-controlled trials with complex data.

  • Should remdesivir be reserved for the treatment of patients with selected risk factors?
  • What is a more effective timing for the use of remdesivir, and should it be used in combination with other agents?
  • How is the course of hospitalization affected by the type and level of care delivered in particular settings?

New England Journal of Medicine

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Editorial