25 March Ongoing Clinical trials

Tue, 03/31/2020 - 21:34

A colleague asked me about hyper-immune serum, corticosteroids etc.

It stimulated me to look up the literature on SARS. You can find the review as download; it shows that the hyper-immune serum trials were very few, showed some effect, but were not very convincing in set-up.  For COVID, 2 trials are ongoing 17 and 18 in my list).

My take is that we would rather need a combination of very potent and broadly neutralizing antibodies.

In the list, selected from ClinicalTrials.gov, you find two main categories:

  1. Antivirals: no surprises
  • a TMPRSS2 serine protease inhibitor, to block maturation of the spike
  • ACE2 receptor inhibitors
  • Rendesivir
  • Hydroxy-Chloroquine in various setting (also prophylactic and post-exposure)
  • Lopinavir.RTV (the first well-controlled trial was published in NEJM and failed)
  • Various drug and combinations
  1. Anti-inflammatory: besides 1 corticosteroid trial, many monoclonals that have shown effects in rheumatoid arthritis, cancer, multiple sclerosis
  2. Stem cells
  3. Viagra (you would not believe it…)

I also include the specific guidelines for COVID trials,  from Europe and Belgium.

Best wishes,