are there any effective treatments?

September 23, 2022

A recent review published in the Journal of American Medicine Association ((JAMA) reviews the currently known efficacy of the treatments under study in the fight against Covid-19. His conclusion is clear for the moment: no treatment is effective.

Since the beginning of the pandemicis the race for treatment. Indeed, finding an effective therapy against Covid-19, whether to treat patients in a severe state, or to prevent people from going to such a state (still it should know how to predict scientifically when this will happen …), an effective drug with a balance benefits / positive risks would be very significant, and even of vital importance.

In this relentless research, we are witnessing a large mixture of heterogeneous studies which provide only too partial evidence to judge the efficacy and the benefit / risk balance of these treatments. Unfortunately even randomized controlled trials do not, for the moment, show miraculous results.

No really effective treatment yet

The journal published in the JAMA brings together a set of very different studies. The authors' analysis is qualitative, not quantitative. They explain that, given the lack of randomized controlled trials, case reports and other reviews are included in their study. The implication is that there is no evidence strong enough to say that a treatment is effective – that is, with an effect greater than one. placebo or the absence of treatment with a positive benefit / risk balance.

Whether it be chloroquine or the hydroxychloroquine that we talk about so much (too much?), the combination lopinavir / ritonavir and the other anti-retrovirals, the classic anti-virals, immunomodulators, the corticosteroids or the plasma of convalescent people, none of these treatments has proven itself in a robust enough way that one can clearly generalize it and have a precise idea of ​​its balance benefit / risk.

Ongoing trials

The investigators also briefly researched clinical trials underway for Covid-19 on ClinicalTrials.gov. They found 351 active trials, including 291 specific trials of Covid-19 as of April 2, 2020. Of these 291 trials, approximately 109 included pharmacological therapy for the treatment of Covid-19 in adult patients. Of these 109 trials, 82 are intervention studies, with 29 placebo-controlled trials.

According to the description of the studies, there are 11 phase 4, 36 phase 3, 36 phase 2 and 4 phase 1 trials. Twenty-two trials were not classified by phase or not applicable. What is more worrisome is that procedures exist to stop ongoing trials if researchers see clear benefits to the condition of patients. Unless an unexpected discovery is made to this pandemic with moderately or moderately effective treatments.

Coronavirus: what treatments are being studied?

By Julien Hernandez on 04/01/2020

In the media hubbub around the chloroquine, we forget to talk about other potential treatments for Covid-19 disease. What are they and what can we expect from them?

Yes, there are other promising treatments being evaluated in addition to the famous chloroquine. The craze around the latter which seems to hinder the realization of the clinical trial Discovery is only media, it is not scientific. It is not yet known whether this treatment, administered to patients infected with SARS-CoV-2, brings more benefits than risks. But let's talk about other treatments today. Those who fail to be evaluated in the shadow of the media, are at the light of the scientific method. All the sources used for this article are accessible by clicking here.

The other “treatments” under study

Many clinical tests of variable quality (randomized, non-randomized, pre-published, published in journals of excellence) are available or in progress concerning treatments used against virus of the'immunodeficiency human (HIV): the liponavir / ritonavir combination. A study recently published in the New England Journal of Medicine reports the ineffectiveness of this treatment. But others antivirals are being studied such as favipiravir or arbidol. However, the published studies concerning the latter are controlled against another treatment. Since little is known about the efficacy of treatments in Covid-19, it is difficult to extract useful information from this kind of comparison. Their use, if it proves effective, seems judicious in first intention, before the patient's condition does not get worse potentially.

  • Monoclonal antibodies

Many monoclonal antibodies such as mepolizumab or tocilizumab are also being studied. The trials published so far do not allow us to extrapolate their effectiveness. They would be useful in inflammation management in severe and critical cases.

Other publications have reported other treatments, but especially in the management of severe cases in order to reduce theinflammation general body. We then find corticosteroids, convalescent plasma injection and transplantation of stem cells mesenchymal that do not express theenzyme conversionangiotensin on their surface. All of these treatments were administered in emergency medical practice, on a very small number of patients. It is therefore difficult to step back on their own effectiveness.

What about the vaccine?

Work is currently underway to try to determine whether the achievement of a vaccine is possible. We already know that in monkeys SARS-CoV-2 infection protects against re-infection of the virus, which is encouraging. Australian teams are also studying the different phases of the immune response in different types of patients, in order to understand the complex mechanisms that should be tried to stimulate thanks to a vaccine. Anyway, the realization of a vaccine is certainly not for now, so we must hope to limit the number of deaths through treatment curative. The data from the Discovery trial should quickly tell us more about this.

To remember 

Other treatments are being studied in addition to hydroxychloroquine which is so much talked about.

At the moment, there is little quality data to be able to treat patients with a mild to moderate form of the disease.

The Discovery study launched across Europe should tell us more about this.

This will also interest you

Chloroquine and COVID19: what to think about it? Chloroquine has aroused enthusiasm among the population after the careless communications of a Marseillaise research team. However, care must be taken. The entire scientific community criticizes and calls for restraint in the interpretation of the results of this study.

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