Ongoing Clinical Trials Find Potential Success With COVID-19 Antiviral

Trials for an antiviral that could help treat COVID-19 patients are underway at University Hospitals, and promising preliminary data could be released soon. The studies are testing the effectiveness of remdesivir for patients with pneumonia as a result of the coronavirus.

Patients enrolled in the trials seem to tolerate the antiviral and recover, said UH principal investigator Leila Hojat, but researchers can’t draw any conclusions at this point.

“Even if there has been benefit, there’s just not enough numbers here at our institution or at any one institution to make much of a conclusion,” Hojat said.

Remdesivir was developed for use against Ebola, but was not effective against it. However, lab tests have shown positive results in using the drug against MERS and SARS, two other coronavirus strains.

About 50 patients have enrolled in UH’s portion of the clinical trials so far. Gilead, the manufacturer of the antiviral, is compiling data from multiple hospitals participating in the study, Hojat said, and is expected to provide more information in coming weeks.

“Lots of patients go home who are on the drug,” Hojat said. “It’s hard to say if that was the drug, or if maybe that was just the way that the virus’s course was.”

The trials follow patients with moderate to severe cases of pneumonia, assessing both a five- and 10-day treatment. The trials are looking for changes in length of hospitalization, and patient temperature and oxygen levels. Patients with moderate cases can be compared to those who just receive supportive care, but there isn't a control group for patients with more severe cases.

“There’s no approved treatments,” Hojat said. “If we think this is the best treatment that’s out there, it’s really not fair or ethical to be excluding patients, or putting them into a control arm and not allowing them the possible benefit of the drug.”

That lack of a control group does mean researchers need to show extra care in analyzing the data, Hojat said.

“It does make analysis of that data a little bit trickier, but I think we’ll still be able to get some information,” Hojat said.

Numerous other possible treatments are currently being tested across the country. The Cleveland Clinic, for instance, is currently involved in a clinical trial for an anti-malarial drug touted by President Donald Trump.

It will take time to evaluate them and determine what is actually effective, Hojat said.

“Unfortunately, I don’t think we’ll have most of that information until after the big surge of patients have come through,” she said.

Even after the surge, Hojat said, remdesivir could prove an effective treatment as people continue to be diagnosed and hospitalized with COVID-19 in the future.

“I think this is promising, and that’s why we’re continuing to enroll patients,” Hojat said. “If we didn’t feel that way, then we wouldn’t be doing this.”