Three anti-inflammatory drugs used to treat malaria, some cancers and Crohn's Disease or rheumatoid arthritis are to be part of a clinical trial for potential treatments for COVID-19 patients, the World Health Organization (WHO) has announced.
The drugs – artesunate, imatinib and infliximab –were selected by an independent expert panel for the Solidarity Plus trial because of their potential in reducing the risk of death in hospitalized COVID-19 patients, the WHO said.
"Finding more effective and accessible therapeutics for COVID-19 patients remains a critical need," said Tedros Adhanom Ghebreyesus, WHO director-general.
The Solidarity Plus trial involves thousands of researchers in 600 hospitals across 52 countries – 16 more countries than the first Solidarity trial.
Because of the trial's size, the WHO says multiple treatments can be assessed at the same time, allowing faster estimates of a drug's effect on mortality and allows potential treatments to be dropped or added as the trial continues.
It also allows new treatments to be added and ineffective treatments to be dropped throughout the course of the trial.
The original Solidarity trial last year found that all four treatments evaluated – remdesivir, hydroxychloroquine, lopinavir/ritonavir and interferon – had little or no effect in helping COVID-19 patients. So far, only corticosteroids have been proved effective against severe and critical COVID-19.
Here are the WHO's briefing notes for the three drugs selected for the new trial:
Produced by Ipca, it is used to treat malaria. In the trial, it will be administered intravenously for seven days, using the standard dose recommended for the treatment of severe malaria. Artesunate is a derivative of artemisinin, an antimalarial drug extracted from the herb Artemisia annua. The WHO COVID-19 Therapeutics Advisory Group recommended evaluating the anti-inflammatory properties of artesunate.
Produced by Novartis, it is used to treat certain cancers. In the trial, it will be administered orally, once a day, for 14 days. The dose used is the standard maintenance dose, which is at the lower end of the dose patients with haematological malignancies are given over extended periods. Imatinib is a small-molecule tyrosine kinase inhibitor, formulated as an oral chemotherapy drug used to treat certain types of cancer. Experimental and early clinical data suggest that imatinib reverses pulmonary capillary leaks. A randomized clinical trial performed in the Netherlands reported that imatinib might confer clinical benefits in hospitalized COVID-19 patients, in the absence of safety issues.
Produced by Johnson & Johnson, it is used to treat diseases of the immune system. In the trial, it will be administered intravenously as a single dose. The dose used is the standard dose that patients with Crohn's disease are given over extended periods. Infliximab is a TNF alpha inhibitor, a chimeric monoclonal antibody that recognizes human TNF alpha. Anti-TNF biologics have been approved for treatment of certain autoimmune inflammatory conditions for more than 20 years, demonstrating favorable efficacy and safety in restricting broad-spectrum inflammation, including in elderly populations who are most clinically vulnerable to COVID-19.