An experimental treatment for the new coronavirus is being tested in the US

Researchers in the US are conducting a clinical trial of a treatment for COVID-19, the illness caused by the new coronavirus, the National Institutes of Health announced yesterday. There are currently over 80,000 confirmed cases of the disease around the world, and it has killed 2,770 people.

Two trials of the drug, an experimental antiviral called remdesivir, have already been up and running in China for a few weeks — and preliminary results appear promising. “There is only one drug right now that we think may have real efficacy and that’s remdesivir,” said Bruce Aylward, an assistant director-general of the World Health Organization (WHO), at a press conference this week.

The US trial is centered at the University of Nebraska Medical Center. The first patient enrolled was passenger repatriated to the US after being on the Diamond Princess cruise ship, which was quarantined off the coast of Japan and had an outbreak of the virus on board. It aims to enroll around 400 people with COVID-19 who are experiencing severe symptoms. Patients with a mild case of the disease who don’t need extra oxygen won’t be included. Participants will be randomly assigned to either receive the drug or a placebo. If the study starts to show that the drug works, the patients in the placebo group will also receive it.

“This is probably the most rapid trial initiation we’ve seen in American history, because the trial was just designed a few weeks ago at the NIH, and we were able to get started right away,” lead investigator Andre Kalil, a professor of internal medicine at the University of Nebraska Medical Center, told The Wall Street Journal.

In lab experiments, remdesivir blocks the activity of the new coronavirus in cells. It’s also effective against MERS and SARS, which are also coronaviruses, in cells. It hasn’t yet been tested against those particular diseases in humans. It was first developed by the pharmaceutical company Gilead to treat Ebola.

The first patient in the US with a confirmed case of the virus was given the drug as part of his treatment, but that wasn’t as part of a clinical trial. He received an infusion under compassionate use, which allows doctors to give experimental drugs to patients when no other options are available. The treatment appeared to help (and it appeared to help individual patients in other countries), but it takes a clinical trial, like the ones that are underway, for experts to conclusively know if it works.

Results from the remdesivir trials in China may be available as soon as April. The US-run trial is scheduled to run through 2023, but there may be preliminary data within the year.


Experts discuss remdesivir during a conference in Wuhan.
Photo by Xinhua / Cheng Min via Getty Images

The remdesivir trials are just a few of the dozens of ongoing clinical trials testing treatments for COVID-19, targeting tens of thousands of patients. The scale and speed of the tests are remarkable — even more so given that, only a few years ago, the public health community was reluctant to use experimental treatments during active outbreaks.

Like with the new coronavirus, there were no proven treatments available for Ebola in 2014 when an epidemic broke out in West Africa. At the start, the WHO was concerned that experimental products would increase the already-high levels of mistrust in health workers, and experts worried that focusing on research studies would take resources away from providing active care to sick patients.

But the WHO quickly outlined recommendations for conducting research during the crisis, and trials on various treatment options started up. Scientists learned useful ways to structure trials and thought through some of the ethical issues involved.

Those approaches were refined in the still-ongoing epidemic of Ebola in Congo, which started in 2018. A study of four different drugs found that two were effective — and did so in the middle of the ongoing outbreak. “This is the first time that a randomized, controlled trial has shown quickly and successfully what the best drugs are in the middle of an ongoing outbreak,” Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, which is part of the National Institutes of Health, told The Verge at the time.

Researchers will hope to repeat that success now. The ongoing outbreak of the new coronavirus is different from the Ebola epidemics because it’s less deadly, but it’s affecting far more people in many more countries around the world. But the ongoing response benefits from those experiences, as will the response to any future public health crises.

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