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Hong Kong, May 9
A two-week course of antiviral therapy combining the power of three drugs has shown promise in treating hospitalized patients with mild to moderate COVID-19 in a carefully conducted Phase 2 clinical trial.
The results of the trial, published in The Lancet, involved 127 adults from six public hospitals in Hong Kong.
The combination of drugs tested in the trial included: interferon beta-1b that was developed to treat multiple sclerosis (MS), lopinavir-ritonavir, which is normally used to treat HIV, and ribavirin, an oral drug for the HIV virus. hepatitis C.
Findings from the phase 2 trial provided evidence that early treatment with triple antiviral therapy in conjunction with standard care is safe and shortens the duration of virus clearance (when the virus is detectable and potentially transmissible) compared to lopinavir-ritonavir alone – average 7 days vs. 12 days – in patients with mild to moderate COVID-19.
People in the triple combination group spent 5.5 days less in hospital on average compared to those in the control group who received only lopinavir-ritonavir treatment.
“Our trial demonstrates that early treatment of mild to moderate COVID-19 with a triple combination of antiviral drugs can rapidly suppress the amount of virus in a patient’s body, alleviate symptoms and reduce the risk to healthcare workers by reduce the duration and amount of virus shedding, “said Professor Kwok-Yung Yuen of the University of Hong Kong who led the research.
“Furthermore, the treatment combination seemed safe and well tolerated by the patients,” Yuen said.
Previous research found that a combination of lopinavir-ritonavir and ribavirin significantly reduced respiratory failure and death in hospitalized patients with severe acute respiratory syndrome (SARS) during the 2003 outbreak.
Interferon beta-1b has been shown to reduce viral load and improve lung problems in animal studies of Middle East respiratory syndrome coronavirus (MERS) infection.
The new study involving COVID-19 patients enrolled 127 adults admitted to one of six public hospitals with SARS-CoV-2 infection (the virus responsible for COVID-19) confirmed by laboratory between 10 February and March 20 of this year.
Participants were randomized to 14 days of the triple combination of oral lopinavir-ritonavir (400 mg / 100 mg) and ribavirin (400 mg) every 12 hours, plus up to three doses of injectable interferon beta-1b (8 million international units). ) in alternative days for patients admitted to the hospital less than seven days from the onset of symptoms (86 patients; combination group); or lopinavir-ritonavir only every 12 hours (41 patients; control group).
In the trial, all patients received standard care, including ventilation support, dialysis support, antibiotics, and corticosteroids.
Treatment with the triple drug combination effectively suppressed viral load (no detectable virus) in the nasopharyngeal swab within an average of 7 days of starting treatment, which was significantly shorter than the 12-day average in the control group, treated with lopinavir-ritonavir alone.
Secondary results supported the findings, indicating that clinical improvement was significantly better in the triple combination group: triple therapy halved the time to complete symptom relief (average of 4 days vs. 8 days). and resulted in a significantly shorter average hospital stay days vs. 14.5 days).
“These findings suggest that interferon beta 1-b may be a key component of combination therapy and is worth further research for the treatment of COVID-19,” said study co-author Jenny Lo of Ruttonjee Hospital in Hong Kong.
“Interferons are naturally-occurring proteins produced in response to a viral infection, and the hope is that interferon beta-1b increases the body’s ability to fight SARS-CoV-2. Future phase 3 trials will soon confirm or will disprove the utility of this drug candidate as a primary treatment for COVID-19 “.
There were no differences in adverse events between treatment groups, and none of the side effects in the combination group were severe.
No patient died during the study.
However, the researchers emphasized the need for larger phase 3 trials to examine the effectiveness of this triple combination in critically ill patients.
IANS
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