A World Health Organization– led global trial of treatments for COVID-19 was slow to enroll coronavirus-infected people, like this one in a Spanish

One U.K. trial is transforming COVID-19 treatment. Why haven’t others delivered more results?

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2021-06-16 17:30:02

A World Health Organization– led global trial of treatments for COVID-19 was slow to enroll coronavirus-infected people, like this one in a Spanish intensive care unit, whereas a large trial in the United Kingdom quickly produced results for three treatments.

On 29 June, University of Oxford clinical scientists Martin Landray and Peter Horby changed how physicians around the world consider treating COVID-19—for the third time in little more than 3 weeks. The principal investigators of a U.K. megatrial called Recovery, which has been testing existing drugs as therapies for the new infection, the pair had just finished reviewing data from 1596 patients who had received a combination of lopinavir and ritonavir, two antivirals known to curb HIV, and 3376 patients who had received only standard care. In a press release, they and their Recovery colleagues announced there had been no significant difference in the death rate between the two groups. “This could have worked. And it was a bust,” says Eric Topol, director of the Scripps Research Translational Institute. “It was really important to clarify that.”

Earlier the same month, and again through press releases, Recovery (Randomised Evaluation of COVID-19 therapy) delivered widely accepted verdicts on two other treatments. It revealed that dexamethasone, a cheap steroid, reduced deaths by one-third in patients on a ventilator and showed that hydroxychloroquine, the antimalarial drug controversially touted for COVID-19, did not benefit hospitalized patients. A run on dexamethasone ensued as physicians in the United Kingdom and elsewhere quickly made it part of their standard of care for the sickest patients, whereas many other studies of hydroxychloroquine now looked futile and were halted.

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