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Drugs not effective for hospitalised COVID-19 patients, study finds

Drugs not effective for hospitalised COVID-19 patients, study finds

The drug combination lopinavir-ritonavir is not an effective treatment for patients admitted to hospital with COVID-19, an NIHR-supported University of Oxford study has reported.

The treatment does not significantly reduce deaths, length of hospital stay, or the risk of needing to be placed on a ventilator, according to results from the RECOVERY study published in The Lancet.

Many clinical care guidelines have recommended lopinavir-ritonavir – an antiviral medication approved to treat HIV/AIDS – for patients hospitalised with COVID-19 and must now be updated, authors say.

RECOVERY is the first large-scale randomised clinical trial to report the effects of lopinavir-ritonavir in hospitalised COVID-19 patients and is taking place at 176 UK hospitals with almost 500 taking part in Berkshire, Buckinghamshire, Oxfordshire and Milton Keynes.

More than 5,000 UK patients received the drug combination or usual care. Results showed:

  • 23% who received lopinavir-ritonavir and 22% allocated to usual care died within 28 days.
  • 69% in the lopinavir-ritonavir group left hospital within 28 days, compared with 70% receiving usual care. Both had a median stay of 11 days.
  • 10% in the lopinavir-ritonavir group needed ventilation, compared with 9% in those receiving usual care.

Professor Martin Landray, trial co-lead, said: “Treatment of COVID-19 with the drug combination lopinavir–ritonavir has been recommended in many countries. However, results from this trial show that it is not an effective treatment for patients admitted to hospital with COVID–19.”

Co-Chief Investigator Professor Peter Horby said: “Whilst it is disappointing that there was no significant benefit from lopinavir-ritonavir for patients in hospital, these findings have allowed us to focus our efforts on other promising treatments, and have informed the way in which individual patients are treated.”

The findings are the latest discovery from the trial, where potential treatments can be added and removed as the study progresses.

In June, the study reported that hydroxychloroquine has no beneficial effect for hospitalised COVID-19 patients.

Later that month, the study reported that Dexamethasone, a steroid already used to reduce inflammation, reduced the risk of dying by a third in ventilated patients and a fifth in those receiving oxygen only. This was the first drug identified to improve survival in COVID-19 patients.