Remdesivir, hydroxychloroquine, lopinavir/ritonavir, and Interferon used for treating COVID-19 not quite effective: Solidarity Trial

USA: Four re-purposed antiviral drugs including remdesivir, hydroxychloroquine, lopinavir/ritonavir, and Interferon-β1a used for the treatment of the COVID-19 virus are not quite effective, reveals Solidarity Therapeutics Trial coordinated by the World Health Organisation (WHO). Solidarity is an international clinical trial to help find an effective treatment for COVID-19, launched by the World Health Organization and partners.

The regimens appeared to have little or no effect on 28-day mortality or the in-hospital course of COVID-19 among hospitalized patients.

The world's largest randomized control trial on COVID-19 therapeutics has generated conclusive evidence on the effectiveness of repurposed drugs for the treatment of COVID-19 in just six months. 

WHO expert groups recommended mortality trials in hospitalized COVID-19 of the four re-purposed antiviral drugs which include Remdesivir, Hydroxychloroquine, Lopinavir (fixed-dose combination with Ritonavir) and Interferon-β1a. 

WHO accepted the recommendation from the Solidarity Trial's International Steering Committee to discontinue the trial's hydroxychloroquine and lopinavir/ritonavir arms on 4 July 2020.

The International Steering Committee formulated the recommendation in light of the evidence for hydroxychloroquine vs standard-of-care and for lopinavir/ritonavir vs standard-of-care from the Solidarity trial interim results, and from a review of the evidence from all trials presented at the 1-2 July WHO Summit on COVID-19 research and innovation.

These interim trial results showed that hydroxychloroquine and lopinavir/ritonavir produce little or no reduction in the mortality of hospitalized COVID-19 patients when compared to standard of care. Solidarity trial investigators will interrupt the trials with immediate effect.

For each of the drugs, the interim results did not provide solid evidence of increased mortality. There were, however, some associated safety signals in the clinical laboratory findings of the add-on Discovery trial, a participant in the Solidarity trial.

The study, which spans more than 30 countries, looked at the effects of these treatments on overall mortality, initiation of ventilation, and duration of hospital stay in hospitalized patients. Other uses of the drugs, for example in the treatment of patients in the community or for prevention, would have to be examined using different trials. 

In 405 hospitals in 30 countries 11,266 adults were randomized, with 2750 allocated Remdesivir, 954 Hydroxychloroquine, 1411 Lopinavir, 651 Interferon plus Lopinavir, 1412 only Interferon, and 4088 no study drug.