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Biggest COVID-19 trial tests repurposed drugs first

The United Kingdom has launched the world’s largest clinical trial to evaluate whether existing or new drugs work to treat people hospitalized with Covid-19. The Randomised Evaluation of COVID-19 (RECOVERY) trial is led by University of Oxford researcher Peter Horby, Who previously worked with researchers in Wuhan to publish the first clinical data on the new coronavirus and previously led Ebola drug trials in the Democratic Republic of the Congo. It will follow an adaptive clinical trial design to accelerate the process of identifying effective treatments. Patients who test positive with COVID-19 who enter any of the United Kingdom’s 132 National Health Service hospitals are invited to participate. Over 5,000 patients were enrolled in a month since the trial’s launch in March.

Drugs included in the trial protocol are all existing medicines repurposed for COVID-19: AbbVie’s Kaletra (lopinavir/ritonavir), commonly used to treat HIV infection; dexamethasone, an anti-inflammatory steroid; hydroxychloroquine, an antimalarial drug; and the antibiotic azithromycin. Trial participants are randomized to receive standard of care with one of the study drugs, or standard of care alone. The adaptive trial design allows the RECOVERY team to review the data regularly and quickly add or eliminate treatments, and to incorporate new treatments into the trial as they become available.

The UK-wide trial is supported by a grant to the University of Oxford from UK Research and Innovation and the National Institute for Health Research (NIHR) and by core funding provided by the NIHR Oxford Biomedical Research Centre, Wellcome, the government’s Department for International Development, Health Data Research UK, the Medical Research Council Population Health Research Unit, NIHR Clinical Trials Unit support funding and the Bill and Melinda Gates Foundation. The foundation has pledged more than $250 million to the global COVID-19 response, in particular to support African and South Asian countries to roll out detection, treatment and isolation programs.

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Biggest COVID-19 trial tests repurposed drugs first. Nat Biotechnol 38, 510 (2020). https://doi.org/10.1038/s41587-020-0528-x

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