Covid-19 CT update: Good News from Hong Kong Phase 2 Triple Combination. Source: Lancet

[sharoncrayn]

A triple-antiviral therapy regimen of interferon-beta1, lopinavir/ritonavir, and ribavirin shortened median time to COVID-19 viral negativity (mild to moderate cohorts) in a small, randomized trial (n=84) done by the University of Hong Kong (China). The median hospital stay was 9 days for patients treated with the combination, compared with 14.5 days for controls (HR 2.72, P = .016) which is very good.

"Patients who received the combination also had significantly shorter time to complete alleviation of symptoms as assessed by a National Early Warning Score 2 (NEWS2, a system for detecting clinical deterioration in patients with acute illnesses) score of 0 (4 vs. 8 days, respectively; hazard ratio 3.92, P < .0001), and to a Sequential Organ Failure Assessment (SOFA) score of 0 (3 vs. 8 days, HR 1.89, P = .041)." (Both HRs were in the good to very good range which is definitively positive-Sharon)

Drugs used:

#1 Interferon-beta1 is re-purposed MS drug (injection).

#2 lopinavir and ritonavir is a re-purposed (2 drugs in one) HIV drug. It showed no success when used alone in terms of covid-19 treatment per NEJM. In this trial, it was apparently the control which is an issue for me.

#3 ribavirin is a re-purposed anti viral primarily for Hepatitis C. Definitely toxic when taken alone and can cause heart SDS.

My one concern: the combination drug lopinavir and ritonavir was the control which we already knew was not successful when used alone. So why use it as the control unless nothing else seems relevant, or it was the most convenient drug to use as the control. I would assume this was the case.

Sharon

[WinnieThePoo]

Sounds promising. I don't understand your point about lopinavir and ritonavir being the control. Was it not part of the combination that was successful? Could you provide a link to the trial?

[sharoncrayn in reply to WinnieThePoo]

Check the Lancet.

"I don't understand your point about lopinavir and ritonavir being the control."

It was somewhat confusing I admit. Apparently they choose L/R even though "as a single drug" (my emphasis) it showed no efficacy as reported in the NEJM.

My own personal opinion is that this type of control (which is known to be ineffective on its own) can easily skew the results in a positive manner when nothing is really, clearly positive. I'm not saying this happened, but it can, so why even go that route.

Any type of covid-19 CT using meaningless placebos or using a non-efficacious drug is a waste of time with this toxic virus...given the circumstances. If Rem...is being promoted as a possible answer, then go "head-to-head". Let's move forward quickly without wasting valuable time.

Sharon

[MBAnderson]

thank you Sharon