Health
Kaletra again fails with moderate to severe COVID-19
Lopinavir-ritonavir (Kaletra), a protease inhibitor primarily used for HIV, did not reduce mortality or accelerate recovery from the UK’s massive COVID-19. Recovery trial I affirmed.
Mortality at 28 days was 23% in hospitalized COVID-19 patients randomized to lopinavir-ritonavir (400 and 100 mg, respectively for 10 days or discharge), compared with 22% in the regular care group (22%). Rate ratio [RR] 1.03, 95% CI 0.91-1.17).
The same was true for all pre-specified subgroups, including gender, age, duration of illness, degree of baseline respiratory support, and expected risk of death.Peter Horby, MD, PhD, and colleagues at Oxford University, UK Lancet..
Secondary endpoints were similar to lopinavir-ritonavir and routine care.
- Time to discharge of survivors (median 11 days for both groups)
- Percentage of survivors and excretions within 28 days (RR 0.98, 95% CI 0.91-1.05)
- Invasive mechanical ventilation or death in persons not intubated at baseline (RR 1.09, 95% CI 0.99-1.20)
RECOVERY, a UK-based, practical trial that randomizes inpatients to a variety of open-label treatments, has previously Benefits of COVID-19 initial mortality with dexamethasone.. Other arms included tocilizumab (Actemra), convalescent plasma, REGN-CoV2 combined monoclonal antibody, and azithromycin, but the hydroxychloroquine arm was terminated.
A study of 5,040 patients “provides stronger evidence than ever before regarding the potential therapeutic effect of lopinavir-ritonavir.” 199-Patient study from China Similar findings and interim results WHO Solidarity Trial, Mention the accompanying editorial.
These early results, along with well-documented side effects and drug interactions of the drug, Recommendations of the National Institutes of Health Lopinavir-Ritonavir use in non-clinical inpatients with COVID-19.
Lopinavir-The Hobby group urged that many other clinical care guidelines recommending ritonavir need to be updated.
Nonetheless, early antiviral treatment may be worth testing for post-exposure prophylaxis in mild cases or high-risk populations of COVID-19, editor of the National Center for Respiratory Disease Clinical Research in Beijing. Bin Cao, MD, and Frederick Hayden, MD of the University of Virginia School of Medicine in Charlottesville.
“Early use of sufficiently potent antivirals is an important determinant of clinical outcome given the association between efficient replication of SARS-CoV-2 immediately after infection and diagnostic mortality and viral RNA loading. The intervention trial has been completed. “
They also need to study antiviral and immunomodulatory combinations, as monotherapy may not be sufficient for patients with moderate to severe illness hospitalized with COVID-19. Insisted.
According to Horby and co-authors, the limitations of RECOVERY study data include “difficulty in treating patients who cannot swallow, such as the possibility of blocking feeding tubes with crushed tablets and unreliable bioavailability. Included the enrollment of a small number of intubated patients. ..
Disclosure
This study was funded by the Medical Research Council and the National Institute of Health.
The researchers did not reveal a conflict of interest.
Cao revealed that he worked closely with the author of an article on treatment research for influenza and COVID-19. Hayden reports personal rates from the University of Alabama Antiviral Discovery and Development Consortium and Wellcome Trust to develop treatments or vaccines for COVID-19 or MERS such as Arcturus, Cidara, Fujifilm, Gilead Sciences and GSK. I was an unpaid consultant for a company. Merck, Pardes Biosciences, Regeneron, resTORbio, Ridgeback Biotherapeutics, SAB Biotherapeutics, Takeda, and Vir. He is a member of the CytoDyn-funded clinical trial data safety monitoring committee and pays his center. He is also the co-author and co-author of publications with multiple authors of the paper.
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