An important clinical trial of four experimental therapies against the emerging corona virus began in a number of European countries, evoking varying degrees of hope. Here is a tour of this large-scale experiment against the Covid-19 epidemic that is currently untreated.
METHODOLOGY The "Discovery" experience, which started on Sunday, will include 3,200 European patients in France, Belgium, the Netherlands, Luxembourg, the United Kingdom, Germany and Spain, as well as other countries can join.
Each of the patients participating in the trial receives one of the four treatments under test, not decided by the doctor, but is chosen randomly by computer. And an infectious disease specialist at the "La Croix Ross" University Hospital in Lyon, France, Florence Adair, who is the project manager, explained during a press conference, "This allows selection of the sample of the experiment."
Concerned patients in France, 800 people participate in the experiment, they are exclusively hospital patients, whether in the infectious diseases department or in the resuscitation department.
Professor Adair explained that these participants are patients who suffer from symptoms of the respiratory system, especially pneumonia, and / or they need oxygen.
She added that they were given treatment quickly "because the period for direct treatment is apparently an important factor in relation to this disease." Professor Bruno Lena, a specialist in virology at the University Hospital in Lyon, explained that the more early the disease is, the more limited the presence of the virus, and therefore, "If we want the compound to have an effect against the virus, we must treat the patient with it at a very early stage." .
The basic molecules in question: There must be two factors in each of the basic compounds that are being tested, which are the efficacy and the patient's ability to bear it.
Remisdiver:
It is an anti-viral drug that was originally prepared against Ebola but "its range of effectiveness is broader" because it "interacts with other viruses, and is especially capable of stopping the proliferation of the new corona virus," according to Bruno Lina.
"We attach high hopes to this molecule" because "the initial results in the laboratory were very good," the virologist added.
A mixture of lopinar and ritonavir:
The researcher explained that this treatment re-uses an anti-AIDS drug that "prevents the reproduction of the virus," adding "we have seen meaningful results in the laboratory."
This combination of the two drugs was tried in China, but the results were mixed, especially since many patients "were included in the experiment very late, some after the tenth day of the disease", according to Bruno Lina. Consequently, the "discovery" experiment that began much earlier than the evolution of the Covid 19 epidemic would be "complementary" to the Chinese experience.
The same mixture of lopinar and ritonavir, but with interferon beta:
This mixture of molecules is very interesting in relation to the Covid-19 epidemic, as the disease includes two stages: the first is a viral stage, "we believe that antiviral drugs can have a major effect on them", and the stage of "inflammatory syndrome that can lead to impaired lung function , And we hope that interferons can stop this inflammatory process, "according to the virologist.
Hydroxychloroquine:
This fourth treatment, close to chloroquine, is an anti-malarial drug that raises much controversy as it was not initially proposed for trial, and was added to the list at the request of the World Health Organization and the French state.
"It seemed to us logical" to add it after "we received new data," in particular a Chinese study released on March 9 in the largest US newspaper specializing in infectious pathology, which included a number of interesting arguments, "said Ader.
Why is hydroxychloroquine tested instead of chloroquine? Both substances have the same effect, but the toxicity level is lower in hydroxychloroquine.
Duration of the experiment
The first treatments for patients began in France on Sunday at the Besha Hospital in Paris and the University Hospital in Lyon. Hospitals will be chosen "according to the epidemic spread map," according to Adair, provided that the selection of the 800 French patients is completed "as soon as possible."
In other countries, "it will depend on the ability of countries to begin all their experiences."
The first clinical evaluation of the trial will take place on the fifteenth day of treatment, "that is, in the following weeks the first results will begin to appear."
Once any of the experiments prove "superior to one of the four methods of treatment, it will be possible to suggest its use on the regulatory bodies concerned with permits to use medicines in France and the world," according to what the experts said.
Then it becomes possible to provide the medicine "quickly" as the world suffers from "a lack of treatment", but experts called for "caution" because "the effects of (the medicines under trial) are not yet known."