WHO to test three more potential COVID-19 treatments

With so much misinformation about potential treatments for COVID-19 circulating online and beyond, the need for large-scale trials to test often repurposed drugs remains high.

Several such trials are ongoing, including the RECOVERY trial in the UK and the Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV) in the US.

The biggest is the World Health Organization’s Solidarity trial, which is now being expanded. Solidarity PLUS will test three more potential treatments in a trial that will involve thousands of researchers in over 600 hospitals in 52 countries, 16 more countries than the first phase of trials.

The drugs – artesunate, imatinib and infliximab – were selected by an independent expert panel for their potential in reducing the risk of death in hospitalised COVID-19 patients.

“Finding more effective and accessible therapeutics for COVID-19 patients remains a critical need, and WHO is proud to lead this global effort,” said WHO director-general, Dr Tedros Adhanom Ghebreyesus.

Artesunate is a derivative of artemisinin, an antimalarial drug extracted from the herb Artemisia annua, but it’s the drug’s anti-inflammatory properties that attracted the interest to the Solidarity expert panel. The drug will be administered intravenously for seven days.

Hailed as a miracle anticancer drug when it was launched in 2008, Novartis’ Gleevec (imatinib), a small molecule tyrosine kinase inhibitor, may help COVID-19 patients due to its ability to reverse pulmonary capillary leak. Imatinib is the most convenient of the three and will be given orally once a day for 14 days.

The third drug, Johnson & Johnson’s Remicade (infliximab), has been used to treat autoimmune inflammatory conditions for more than 20 years, including Crohn’s Disease and rheumatoid arthritis. Biosimilars are available, although the company has been involved in a prolonged lawsuit with Pfizer relating to anticompetitive activities, which was settled recently. Infliximab will be administered intravenously as a single dose.

As before, Solidarity PLUS will have the ability to add new treatments and drop any shown to be ineffective during the course of the study.

Last year, WHO announced that four drugs tested in its Solidarity trial, touted as effective treatments for severe COVID-19 infection – remdesivir, hydroxychloroquine, lopinavir/ritonavir and interferon – had little or no effect on hospitalised patients with COVID-19.

More recently, Gilead revealed additional data for remdesivir (Veklury) from three retrospective studies covering real-world treatment of hospitalised COVID-19 patients, and is approved for use. Hydroxychloroquine and lopinavir/ritonavir (AbbVie’s Kaletra) are not being used currently, while UK-based biotech Synairgen has an ongoing trial investigating an inhaled formulation of Interferon-beta-1a in COVID-19 patients.