In the UK, the world’s largest clinical trial of potential coronavirus treatments, the Randomised Evaluation of COVID-19 Therapy trial (RECOVERY), is underway. It is aimed at assessing the effects of different treatments, including repurposed and novel drugs, on major outcomes in COVID-19.
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The trial began on 19 March, and has been progressing rapidly – 9 days for first protocol to first patient and 13 days to reach 500 patients, while around 1,000 patients from 132 different hospitals have enrolled in the first 15 days. Every COVID-19 patient in the UK over the age of 18 years may be invited to participate. Those having accepted are randomly allocated to standard of care alone, or standard of care plus one of the additional treatments. Specifically, randomisation will initially be to one of the following arms:
- Usual care.
- Usual care plus lopinavir-ritonavir (commonly used to treat HIV).
- Usual care plus low-dose dexamethasone (a type of steroid use in a range of conditions to reduce inflammation).
- Usual care plus hydroxychloroquine (a treatment for malaria).
The option of usual care plus inhaled interferon is yet to start. In general, the design of the study allows further medicines to be added within days after they have been identified.
The above treatments have been recommended by an expert panel advising the Chief Medical Officer for England. If any of the them is scientifically supported, it will be immediately applied to treat NHS patients. Definitive results are expected within months.
Health and Social Care Secretary Matt Hancock said this trial marked “a major milestone in our battle against coronavirus.”
The trial is being coordinated by researchers at the University of Oxford, led by Peter Horby, Professor of Emerging Infectious Diseases and Global Health in the Nuffield Department of Medicine, and Martin Landray, Professor of Medicine and Epidemiology at the Nuffield Department of Population Health.
The study has received €2.4 million (£2.1 million) from UK Research and Innovation (UKRI) and the Department of Health and Social Care. It is part of a wider €23 million (£20 million) rapid COVID-19 research response investment by the UK government. The other two key national trials are PRINCIPLE and REMAP-CAP.
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