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The search for therapeutic solutions against the Wuhan coronavirus does not stop. The last idea: a bullet with triple ammunition, or what is the same, three antivirals to eliminate the effects of the virus before it advances and conquers the organism.

Specifically, it involves the early use of a new antiviral therapy composed of interferon beta-1b, lopinavir-ritonavir (association known as Kaletra) and ribavirin , together with standard support measures, it is safe and shortens the duration of viral spread. in the body, compared to the single administration of lopinavir-ritonavir (an average of seven days of reduction compared to 12 days, respectively), in patients affected by mild to moderate Covid-19 .

Data from this first phase II randomized trial are published today in The Lancet and have analyzed 127 adults - from 18 years of age and with an average age of 52 - with SARS-CoV-2 infection admitted to six public hospitals in Hong Kong. Kong. These early findings, but important in the fight against this new disease, do not include, however, severe pictures , so the authors of the research, from the University of Hong Kong, in China, stress that the need to develop more studies Phase III tests to assess effectiveness on critics.

The director of the analysis, Kwok-Yung Yuen , a professor at the University of Hong Kong, explains that early treatment of mild to moderate Covid-19 with a triple antiviral combination "can quickly decrease the amount of virus in the virus. patient's body and relieve symptoms. An added advantage is that the risk for health workers is also reduced, since by subtracting the duration and amount of viral spread (at which time the virus is detectable and potentially transmissible), the possibility of contagion is less. " In addition, the director points out that it is safe and well tolerated.

Background of this therapeutic idea

Previous research found that a combination of oral lopinavir-ritonavir - an association normally used to treat HIV - and ribavirin - an oral drug against the hepatitis C virus (HCV) -, reduced respiratory failure and death in hospitalized patients with respiratory syndrome. severe acute (SARS) during the 2003 outbreak. Interferon beta-1b - with antiviral, antiproliferative and immunomodulatory action - has been shown to reduce viral load and improve lung problems in animal studies of respiratory syndrome coronavirus infection from the Middle East (MERS).

However, on the association of lopinavir and ritonavir, a study published in The New England Journal of Medicine last March suggested that the combination did not provide significant benefits in Covid-19. This fact together with its severe cardiac and gastrointestinal effects meant a decrease in its use , according to experts consulted by EL MUNDO.

Juan Berenguer , consultant for Infectious Diseases at the Gregorio Marañón Hospital in Madrid, comments that, despite the originality of the work, as it is based on a triple treatment and generates interesting hypotheses, “the reality is that, in principle, nothing changes the practice current clinic and maintains certain limitations . Also interesting is the fact that the investigating group has revived a guideline already used for previous SARS outbreaks . ”

Up to 86 participants received 14 days of triple combination treatment every 12 hours , together with more than up to three doses of injectable interferon beta-1b, on alternative days, for patients admitted to the hospital less than seven days from the start of the symptoms. The control group, 41 patients, received lopinavir-ritonavir only every 12 hours. In addition, all received standard care as well, including ventilation, dialysis, antibiotics, and corticosteroids. The average number of days from the onset of symptoms to the start of study treatment was five days.

Hopeful results, but more trials are needed

Analyzing the evolution of symptoms and changes in laboratory findings, it was observed that treatment with the triple combination of drugs ended the presence of the pathogen (without detectable virus) in the nasopharyngeal samples within an average of seven days of starting treatment, which was significantly shorter than the 12-day mean in the control group treated with lopinavir-ritonavir alone. Secondary results supported the findings, “indicating that triple therapy cut the time to complete symptom relief in half; an average of four days compared to eight ».

According to Jenny Lo of Ruttonje Hospital in Hong Kong, China , and co-author of the paper, "it is suggested that interferon beta 1-b may be a key component of combination therapy and deserves further research for the treatment of Covid-19 . Future phase III trials will confirm or refute the usefulness of this candidate drug as the main treatment for this disease. "

The authors highlight, however, several limitations of the study , in which Juan Berenguer agrees, including that it was an open trial in which both the researchers and the patients knew the treatment that the participants were receiving and did not have a placebo group .

According to the criteria of The Trust Project

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  • China
  • Hong Kong
  • Covid 19
  • Science and health
  • Coronavirus
  • Pharmacology

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