HIV drug combo approved by ICMR for coronavirus treatment fails clinical trials in China

Anti-HIV drugs Lopinavir and Ritonavir were administered to treat two Italian tourists in India who had tested positive for the coronavirus infection.

Medics screen patients as part of a precautionary measure against novel coronavirus | Representational image | PTI

New Delhi: A combination of anti-HIV drugs, which the ICMR approved for use in severe cases of COVID-19 infections, has failed initial clinical trials.

Earlier this month, a combination of anti-HIV drugs Lopinavir and Ritonavir was administered to treat an Italian couple who had tested positive for the coronavirus infection.

Following their recovery, the Indian Council of Medical Research (ICMR) had approved the use of this drug combination in patients above 60.

However, one of the two patients, a 69-year-old Italian tourist, later died of cardiac arrest at a private hospital in Jaipur.

A randomised, controlled, open-label trial conducted among 199 COVID-19 patients in China shows that the treatment with Lopinavir–Ritonavir drug combination led to no different outcomes when compared to standard care in terms of time taken for clinical improvement.

The study showed the 94 patients who were given Lopinavir–Ritonavir experienced more adverse gastrointestinal problems, such as vomiting and diarrhoea, as compared to those who received standard care, which included supplemental oxygen, ventilator support and antibiotics.

The study, however, noted that the number of days spent in ICU was shorter for patients treated with Lopinavir and Ritonavir, though the overall duration of hospital stay was no better.

The researchers noted that their trial included patients who were already severely ill, and had higher mortality rates than usual.

“In conclusion, we found that lopinavir–ritonavir treatment did not significantly accelerate clinical improvement, reduce mortality, or diminish throat viral RNA detectability in patients with serious Covid-19,” they wrote.

Developing new drugs from scratch is a challenge

As of Tuesday, India has over 400 active cases of coronavirus patients. Scientists across the world are racing to develop vaccines and find treatments for the infection.

Given the speed at which the infection is spreading, developing new drugs from scratch presents a challenge. Medical experts are hence turning to repurposing existing drugs to combat the pandemic.

For example, the ICMR Monday approved the use of anti-malarial drug hydroxychloroquine as a preventive measure for those at high risk of infection, such as medical professionals and family members of patients.

Another example is an experimental ebola drug, Remdesivir, which is also showing promising results in China.

Meanwhile, even as trials in China have shown negative results, the World Health Organization is also looking to gather more data on Lopinavir and Ritonavir through ‘global megatrials’.