Medical research on the frontline in the fight against coronavirus! During the press brief on the evolution of Covid-19 held this Sunday April 19, 2020 and hosted by Edouard Philippe and Olivier Véran, infectious disease specialist in the infectious disease department at the Croix-Rousse des Hospices civils hospital in Lyon Florence Ader gave an update on the Discovery trial, a European clinical trial testing 4 experimental treatments against Covid-19 she’s in charge of and on the evolution of the current research in the different participating hospitals in France and Europe.
But prior to give an update on this trial, what is it about? Launched this March 23rd, this clinical trial coordinated with the French National Institute for Health and Medical Research (Inserm) is available in seven European countries, includes over 3000 patients – including circa 700 in France for a total goal of 800 – and focuses on four experimental treatments against Covid-19, in association with standard medicines: remdesivir, hydroxy-chloroquine, Kaletra (mix of lopinavir and ritonavir), as well as Kaletra mixed with interferon beta. Experimental treatments have been set up randomly, but the content of the cure given is known by the patient and the doctor. “It’s undoubtedly the first time in the history of pandemics that we are able to run researches in real time” professor Ader said.
Discovery Trial, update
As for the update on the clinical trial on April 19, the infectious disease specialist first gave details as for the choice of anti-retroviral tested during the trial, as well as the research process: “We led a certain number of works in vitro, that is to say in a laboratory, and we kept a certain number of molecules that were molecules we used in AIDS or another molecule already tested in Ebola” she explains. She continues: “We tested other drugs that are not necessarily drugs and medicines used for viral infections, and especially chloroquine and hydroxychloroquine that are medicines we use against malaria”.
Researches in laboratory led to choose four treatments, and a trail with an extremely thorough process to avoid any controversy: “We’ve been extremely thorough on the regulation, that is to say the committee protecting people to have all the green lights we needed to carry out these trials, and of course the authorization from the French Agency for the Safety of Medicine and Health Products” she said. Precautions for results that cannot be easily debatable as they are supported and controlled by health authorities.
But today, it's a damper: in an opinion column released in Le Monde on Saturday May 2, professor Yazdan Yazdanpanah explained that so far, excluding France running the project, only Luxembourg recruited patients to be included in the trial. 60 of them being counted, they included the study only in late April. What about German, Austrian, British or Portuguese patients announced by the heads of this study? No country has included patients so far. France is responsible, after asserting too early on the official organization of a "European trial" by including its partners late. Mistake is also due to a lack of budget, other countries not being able to anticipate the financing of such a project.
A trial based on what we know of coronaviruses
And what about results? So far, no statement, but a guide line to end to a treatment based on what we know of the other coronaviruses: “The idea is that when we make progress and when we understand the way the virus is structured better, the way it works and the way it interacts with the organism, it enables you to get strategies completely proper to the virus” the infectious disease specialist says.
She carries on: “it leads to two innovations that are on one hand to find targets enabling us to create new medicines, but completely proper to this virus – those are medicines said of “second generation” – and we’re already in this dynamic. And of course, the holy grail is to find a vaccine or vaccines that are specific enough to generate an immune response completely targeting this virus”.
As to know when convincing results will be released, you have to wait a little. Note that the first vaccines currently studied at the Institut Pasteur among others, are expected to be tested on patients by summer. Good news giving hope to French and enabling to consider phasing out of the crisis better.