New antiviral drug combo shows early promise for treating COVID-19

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In a new study, researchers found that a two-week antiviral therapy with drugs interferon beta-1b plus lopinavir-ritonavir and ribavirin, started within 7 days of showing COVID-19 symptoms, is safe and more effective at reducing the symptoms than lopinavir-ritonavir alone in patients with mild to moderate illness.

This is the first clinical study of this triple combination therapy involving 127 adults (aged 18 and older) from six public hospitals in Hong Kong.

The new study suggests that clinical improvement and length of hospital stay may be much shorter in people treated with triple combination less than 7 days after showing symptoms, compared to lopinavir-ritonavir alone.

The research was conducted by a team from HongKong.

Experience with influenza, which has a high viral load around the time symptoms appear, suggests that treating patients with a combination of multiple antiviral drugs may be more effective than single-drug treatments, and minimize the risk of antiviral resistance.

The team hypothesized that this could be a possible therapeutic approach for COVID-19, in which the viral load also peaks around the time of symptom onset.

Previous research found that a combination of oral lopinavir-ritonavir (normally used to treat HIV) and ribavirin (an oral hepatitis C virus drug) strongly reduced respiratory failure and death in patients with the severe acute respiratory syndrome (SARS) during the 2003 outbreak.

Interferon beta-1b, which was developed to treat multiple sclerosis (MS), has been shown to reduce viral load and improve lung problems in animal studies of Middle East respiratory syndrome (MERS) coronavirus infection.

The current study demonstrates that early treatment of mild to moderate COVID-19 with a triple combination of antiviral drugs may rapidly suppress the amount of virus in a patient’s body, relieve symptoms, and reduce the risk to health-care workers by reducing the duration and quantity of viral shedding.

Furthermore, the treatment combination appeared safe and well-tolerated by patients.

The team says these early but important findings do not include severe cases of COVID-19, and the authors stress the need for a larger phase 3 trials to examine the effectiveness of this triple combination in critically ill patients.

The lead author of the study is Professor Kwok-Yung Yuen from the University of Hong Kong.

The study is published in The Lancet.

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