WHO trial finds no benefit of 4 drugs for hospital COVID patients

None of the four once-promising drugs evaluated for the treatment of COVID-19 in the ongoing World Health Organization (WHO) Solidarity Trial—remdesivir, hydroxychloroquine, lopinavir, or interferon-beta-1a—prevented in-hospital death, reduced the need for ventilation, or shortened the duration of hospitalization.

The interim results of the open-label study, published yesterday in the New England Journal of Medicine, involved randomly assigning hospitalized COVID-19 patients equally to whichever trial drugs were available locally or to a control group from Mar 22 to Oct 4.

All four drugs were already in use for other indications and repurposed as potential treatments for the novel coronavirus.

The study involved 11,226 patients in 405 hospitals in 30 countries in all six WHO regions assigned to receive one of the four drugs or be part of a control group. Some patients assigned to interferon also received the HIV antiviral drug lopinavir. The control group received hospital-specific standard care. Adherence to the regimens was 94% to 96% halfway through the treatment period.

A total of 1,253 patients (11.2%) died after a median of 8 days. The Kaplan-Meier 28-day death rate was 11.8% but rose to 20.4% in patients older than 70 years and 39.0% in patients already receiving ventilation at study arm assignment.

Of the 2,743 patients who received remdesivir, 301 died, as did 303 of the 2,708 patients in its control group (rate ratio, 0.95). Of the 947 patients in the hydroxychloroquine group, 104 died, as did 84 of the 906 in its control group (rate ratio, 1.19).