Coronavirus: what results for ongoing clinical trials?

Audio 4:17

By: Simon Rozé Follow

Covid-19 still has no treatment. Until research progresses, several clinical trials are underway around the world. Are we starting to get results?

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The so-called “repositioning” tests are still in progress. They consist in using an already existing drug to see if it is effective against Covid-19. It is the fastest method since it does not require developing a molecule from scratch. Much has been said about the Discovery trial in Europe, which is testing four different antiviral strategies to slow down or even prevent the spread of the virus, but we will have to wait to get the results.

Florence Ader is an infectious disease specialist in Lyon. She is piloting the test. She explains that " It is a disease which is of rather slow evolution, with a first phase which one can consider that it lasts approximately one week, and a second phase which lasts approximately one additional week. If we add up all this, we are at D + 15. We consider that to evaluate the therapies offered to patients, it is 15 days after inclusion in the protocol, ”she says. Then she explains: “ This means that we include patients every day, and that the first assessment point for each patient is 15 days later. For the global analysis of the first 100, 200, 300 patients, we will have to wait until each patient has crossed this threshold of the fifteenth day. This means that for the first results, nothing will be available before the end of the month. "

Just over 500 patients have so far been recruited for this trial. There will be 3,200 over time. The advantage of the trial is that it is adaptive: if one of the treatments tested shows its ineffectiveness quickly enough, it will be withdrawn from the study. For the moment, four strategies are being tested: remdesivir, an antiviral developed against Ebola, the combination lopinavir / ritonavir, used against HIV, this same association with molecules that stimulate the immune system, and hydroxychloroquine .

Plasma to boost our immune response

Another strategy was discussed this week: boosting our immune response. The results of a Chinese study were published two days ago. Unfortunately it is restricted. It only affects ten patients because it is a pilot study. A proof of concept that tries to determine whether or not it is worth taking the time to engage in a research strategy. And for the trouble, it seems to be worth it since the results are very promising. It is therapeutic plasma.

Karine Lacombe, head of the infectious and tropical diseases department of Saint-Antoine hospital in Paris has just launched a larger clinical trial on the subject. “ It is based on a fairly simple concept that has been known for a long time to treat certain severe viral infections, which is the transfusion of convalescent plasma. This consists of a transfer of passive immunity between a patient who has recovered from the infection and who is therefore carrying neutralizing antibodies, to patients who are currently sick and who have not yet produced enough antibodies to fight the virus, ”she describes. Then add: “ There are preliminary results which are quite interesting from a series of cases from China. And we want to show if this principle works in a slightly better constructed trial where we will have patients who will receive plasma and patients who will be a control group who will benefit from standard care. "

This trial is called "Coviplasm", 60 patients are enrolled in it. The first results will also be known by the end of the month. With other complementary studies carried out in the world, they will confirm or invalidate the Chinese results which showed after three days of treatment an alleviation of the main symptoms of Covid-19 like cough and breathing difficulties. Even better: after seven days, the lesions on the lungs began to subside. But again, with only ten patients in this study, there is still time for research.

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