WHO launches trials on drugs as search for cure picks pace

The World Health Organisation (WHO) is carrying out trials on a variety of existing drugs to see if they have any effect on coronavirus.

Scientists have indicated that the earliest a vaccine for coronavirus, also known as Covid-19, can be developed is after one year.

A total of 318,505 coronavirus cases have been reported around the world. There have been 13,671 deaths while 96,011 have recovered. China leads in the number of reported cases at 81,054 but Italy has recorded the most deaths at 4,825.

WHO Director General Tedros Ghebreyesus said the trials seek to establish the reaction of the virus to existing drugs.

Dr Ghebreyesus noted multiple small trials with different methodologies might not give them clear evidence they need to know which treatment would be needed to save lives.

That is why the global health agency has embarked on ‘a large international study’ it has termed as ‘solidarity trials’ that will involve several countries and WHO’s partners. The studies are aimed at generating data that can be used to determine the likely potential of some of the existing drugs to treat Covid-19.

Systematically evaluate

“We commend the researchers around the world who have come together to systematically evaluate experimental therapeutics,” Ghebreyesus said.

Simplified procedures that even smaller hospitals that have been burdened by the crisis can incorporate are being used in these trials.

At least 10 countries have already signed up to participate in the trials that will involve multiple studies. 

There are at least five areas the trials will focus on, according to WHO. These include medical standard of care in the participating countries.

This standard of care is the regular supportive management that hospitals treating Covid-19 patients use. They include use of supplemental oxygen and fluid for rehydration when needed.

“Countries will choose from five evaluated therapeutics,” said Ana Maria Henao, the head of WHO’s research and development unit.

The “solidarity trials” will be carried out on four drug molecules and combination of molecules that are already being used to treat other diseases such as malaria and HIV.

These drugs are said to have shown some evidence of an effect on the virus, either in vitro and/or in animal studies.

Too small

A “small” French study of hydroxychloroquine, a medication used to prevent and treat certain types of malaria, has shown to be able to reduce novel coronavirus load on the sixth day in patients who used it. Its sample size of 20 is, however, too small to significantly advise future use.

“Despite its small sample size, our survey shows hydroxychloroquine treatment is significantly associated with viral load reduction or disappearance in Covid-19 patients and its effect is reinforced by azithromycin,” the authors of the study said.

Azithromycin is an antibiotic used to treat a number of bacterial infections.

Henao said chloroquine, a medication used to prevent and to treat malaria, and which is cheap and regularly used around the world, will also be used in the tests.

Some countries will test chloroquine against the standard of care while others will test hydroxychloroquine, a related drug. The anti-malarials will be used with no additional combination of drugs such as antibiotics.

The other drug under research is Remdesivir developed by Gilead. Studies of the drug in 2014 showed it has potential to treat Ebola, but was sidelined in favour of other forms of treatment.

Since then, studies on Remdesivir have been conducted by scientists on its effect on other coronaviruses, including Sars and Mers. Preliminary results indicated that it could have an effect in interfering with the abilities of the viruses to replicate.

Under investigations

Lopinavir combined with low dose of Rotinavir, currently being used in the management of HIV, is part of the drugs under investigations.

A study in China published by the New England Journal of Medicine, however, concluded that with this ARV, “no benefit was observed beyond standard care.”

Further trials might either confirm this or exclude it as a potential treatment for SARS-CoV-2, which causes Covid-19.

“Randomisation can be adjusted according to drugs available in the hospitals over time,” Henao said.

“Additional arms can be included or dropped according to recommendations by WHO’s global data safety monitoring committee.”

The “solidarity trials” are simple trials that, according to WHO, should not stop other scientists from moving on with their researches as all will contribute to the understanding of Covid-19.

Development of the vaccine is critical because the entire world is waiting for it. The virus outbreak emerged in Wuhan, China, last year.