Searching for effective treatments

Drug development is sometimes described as a pipeline, with compounds moving

from early laboratory development to laboratory and animal testing to clinical trials in
people.

It can take a decade or more for a new compound to go from initial discovery to the
marketplace. Many compounds never even make it that far.

That’s why many medications being eyed as potential treatments for COVID-19
are drugs that already exist.

In a review in the British Journal of Pharmacology, scientists from the United

Kingdom called for wider screening of existing drugs to see if they might work
against the new coronavirus.

They identified three stages of infection at which the virus could be targeted: keeping
the virus from entering our cells, preventing it from replicating inside the cells, and
minimizing the damage that the virus does to the organs.

Many of the drugs being developed or tested for COVID-19 are antivirals. These
would target the virus in people who already have an infection.

Lee says antivirals work better if you administer them sooner, “before the virus has a
chance to multiply significantly.” And also before the virus has caused
significant damage to the body, such as to the lungs or other tissues.

Dr. Robert Amler, dean of the School of Health Sciences and Practice at New York
Medical College and a former chief medical officer at the Centers for Disease Control
and Prevention (CDC) Agency for Toxic Substances and Disease Registry (ATSDR),
says both antivirals and vaccines will be valuable tools in combating COVID-19.
However, he told Healthline that “antivirals are likely to be developed and approved
before a vaccine, which typically takes longer.”

Antivirals
Remdesivir

Developed a decade ago, this drug failed in clinical trials against Ebola in 2014. But it
was found to be generally safe in people. Research with MERS, a disease caused by a
different coronavirus, showed that the drug blocked the virus from replicating.

The drug is being tested in many COVID-19 clinical trials around the world. This
includes studies in which remdesivir is being administered alongside other drugs, such
as the anti-inflammatory drug baricitinibTrusted Source.

The drug is also being tested in children with moderate to severe COVID-19.

In late April, the drug’s manufacturer, Gilead Sciences, announced one of its trials had
been “terminated” due to low enrollment. Gilead officials said the results of that trial
had been “inconclusive” when it was ended.

A few days later, the company announced that preliminary data from another trial of
remdesivir overseen by the National Institute of Allergy and Infectious Diseases
(NIAID) had “met its primary endpoint.”

Dr. Anthony FauciTrusted Source, the institute’s director, told reporters the trial

produced a “clear cut positive effect in diminishing time to recover.” He said people
taking the drug recovered from COVID-19 in 11 days compared with 15 days for
people who didn’t take remdesivir.

More details will be released after the trial is peer reviewed and published.
Gary Schwitzer, founder of HealthNewsReview.org, though, said the
researchers changed the primary endpoint 2 weeks before Fauci’s announcement.

Schwitzer compared that to moving football goalposts closer to make it easier to get a
touchdown.

At the same time, another studyTrusted Source published in The Lancet reported that

participants in a clinical trial who took remdesivir showed no benefits compared to
people who took a placebo.

Despite the conflicting results, the FDA issued an orderTrusted Source on May 1 for
the emergency use of remdesivir.

In early June, federal officials announced their supply of remdesivir will run out by

the end of June. Gilead is ramping up production, but it’s unclear how much of the
drug will be available this summer.

In mid-July, Gilead officials announced results from an ongoing phase III trial of

remdesivir. They said the drug was “associated with an improvement in clinical
recovery and a 62 percent reduction in the risk of mortality compared with standard of
care.” They called it an an “important finding that requires confirmation in
prospective clinical trials.”

Arbidol

This antiviral was tested along with the drug lopinavir/ritonavir as a treatment for
COVID-19.

Researchers reported in mid-April that the two drugs didn’t improve the clinical
outcomes for people hospitalized with mild to moderate cases of COVID-19.

EIDD-2801
This drug was created by scientists at a nonprofit biotech company owned by Emory
University.

Research in mice has shown that it can reduce replication of multiple coronaviruses,

including SARS-CoV-2.

Pharmaceutical company Merck and Ridgeback Biotherapeutics LP signed

an agreement in May to develop this drug. It’s already being tested in a clinical trial in
the United Kingdom.

Unlike remdesivir, EIDD-2801 can be taken orally, which would make it available to
a larger number of people.

Favipiravir

This drug is approved in some countries outside the United States to treat influenza.

Some reports from China suggest it may work as a treatment for COVID-19. These

results, though, haven’t been published yet.

Japan, where the medication is made, is sending the drug to 43 countries for clinical
trial testing in people with mild or moderate COVID-19. Canadian researchers are
testing to see whether the drug can help fight outbreaks in long-term care homes.

Kaletra

This is a combination of two drugs — lopinavir and ritonavir — that work against
HIV.

Clinical trials are being done to see whether it also works against SARS-CoV-2.
One small study published May 4 in the journal Med by Cell Press found that
lopinavir/ritonavir didn’t improve outcomes in people with mild or moderate COVID-
19 compared to those receiving standard care.

Another study, published May 7 in the New England Journal of Medicine, found that
the drug combination wasn’t effective for people with severe COVID-19.

But another studyTrusted Source found that people who were given lopinavir/ritonavir

along with two other drugs — ribavirin and interferon beta-1b — took less time to
clear the virus from their body. This study was published May 8 in The Lancet.

Merimepodib (VX-497)

This drug developed by ViralClear Pharmaceuticals Inc. has been shown previously to
have antiviral and immune-suppressing effects. It was tested against hepatitis C but
had only modest effects.

The company is running a phase II trial of this drug. People with advanced COVID-19
will be randomized to receive either merimepodib with remdesivir, or remdesivir plus
a placebo.

The company hopes to have results by late summer of this year.