UK is funding three major Covid-19 clinical trials in race for cure

LONDON: Whilst no drugs in the world have been clinically proven to treat Covid-19 yet, three major novel coranvirus clinical trials funded by the UK government are in the race to find a cure. The antiviral drug remdesevir, which has undergone clinical trials in the US and China, is not among the drugs being evaluated in Britain.
The Recovery trial, coordinated by Oxford University researchers working with UK hospital doctors, is currently the world’s largest randomised clinical trial of potential coronavirus treatments.It is testing several drugs on hospitalised pre-critical Covid-19 adult patients in Britain.
Now well underway with more than 9,000 adult inpatients who have tested positive for Covid-19 across more than 130 NHS hospitals, it is testing if existing or new drugs — a mix of injections and tablets — can help patients that are hospitalised with confirmed Covid-19. Results on whether these treatments are safe and effective are expected within five to seven weeks, potentially benefiting hundreds of thousands of patients worldwide.
The large-scale randomised hospital-based trial, which has received £2.1 million in UK government funding, is evaluating lopinavir-ritonavir (a drug commonly used to treat HIV which has shown activity against SARS and MERS CoVs); the steroid dexamethasone, which is used in a wide range of conditions to reduce inflammation; hydroxychloroquine (a treatment for malaria which has shown antiviral activity against SARS-CoV-2 in cell culture); and azithromycin (a commonly used antibiotic that has shown benefit in inflammatory lung disease.) Tocilizumab (an anti-inflammatory treatment given by injection) is being used on those patients with progressive Covid-19 (as evidenced by hypoxia and an inflammatory state).
"Recovery is a major trial similar in concept and design to the WHO ‘Solidarity’ international clinical trial for Covid-19 treatments, except remdesivir is not part of it," a senior UK government adviser told TOI.
The other UK trials are the Principle Trial, also managed by Oxford University, which is testing drugs on people above 65 and those above 50 with underlying health conditions who have Covid-19 symptoms. This trial, which has received £1.7 million in UK government funding, is initially testing hydroxychloroquine through GP practices to see if doctors can stem the progression of Covid-19 symptoms in older people and prevent hospitalisation.
The third major UK trial, which is also taking place in 12 other countries, is called the Remap-Cap trial. This global clinical trial is for critically ill Covid-19 patients in ICUs. It uses an innovative adaptive trial design to evaluate a number of treatment options simultaneously.
"In the space around repurposed drugs, the likelihood of a dramatic treatment effect is relatively low and there are probably going to be no absolute game changers in those listed drugs even though they may individually be quite helpful. The government therefore set up Accord, another study, and that started to recruit patients last week," the adviser said.
Accord will accelerate clinical trials in the UK on drugs that are not licensed yet and are still in phase 2 for other diseases, if, after small randomised control trials with Covid-19 patients, there are early signals that they could be game changers. If so, these drugs will be fed into one of these large-scale Covid studies.