Like corticosteroids, anticoagulants are used solely in probably the most severely unwell sufferers the place the purpose is to stop blood clots.
Practically a yr after mysterious pneumonia emerged in China and started its international unfold, there’s nonetheless no silver bullet therapy for COVID-19 regardless of an unprecedented effort to find new medicines or repurpose current medication.
A single-family of low cost, extensively accessible medicines — corticosteroids — has confirmed its effectiveness, however another medication that have been initially hyped have upset.
That is the one therapy that has lowered mortality from COVID-19 , though it has solely been proven to work for sufferers who’re severely unwell in hospital and wish oxygen remedy.
The World Well being Group (WHO), in addition to the European Medicines Company (EMA) has been recommending dexamethasone for these sufferers since September, primarily based on the findings of a giant British medical trial referred to as Restoration.
Dexamethasone can really inhibit the immune system, so it shouldn’t be given to these within the early stage of the illness.
However because of this it really works in those that are very unwell — it acts to tame a runaway immune response, which may set off the irritation characteristically seen in extreme types of illness.
And it seems that it isn’t simply dexamethasone.
Analysis printed in early September within the American medical journal Jama confirmed that different medication in the identical corticosteroid household may be efficient, decreasing mortality by 21 p.c after 28 days for sufferers with extreme COVID-19 .
This led the WHO to advocate “systematic” use of corticosteroids in extreme and demanding sufferers.
Like corticosteroids, these medication are used solely in probably the most severely unwell sufferers. The purpose is to stop blood clots, one of many critical problems of COVID-19 .
What would not work properly sufficient?
For a time this antiviral therapy had the hopes of the world using on it.
The drug, developed for Ebola, was initially considered very promising.
The European Fee introduced that it had ordered 500,000 doses in October, whereas the US granted it everlasting authorization to be used.
Its producer, US pharma big Gilead, has stated the drug boosted 2020 third quarter gross sales by nearly $900 million (756 million euros).
Nevertheless it has not lived as much as expectations.
On November 20, the WHO stated remdesivir shouldn’t be used to deal with COVID-19 sufferers irrespective of how critical their sickness, saying it had “no essential impact” on survival possibilities.
That doesn’t imply it’s proved to be ineffective, however slightly that it had not been proven to enhance affected person outcomes.
There have been additionally considerations about doable unwanted side effects, notably affecting the kidneys, in addition to the drug’s value.
The WHO recommendation was primarily based on 4 worldwide randomised medical trials involving greater than 7,000 sufferers hospitalised with COVID-19 .
What doesn’t work in any respect?
This drug turned a lightning rod for politicised debates over the pandemic.
Used as a therapy for malaria or autoimmune illnesses, relying on the nation, hydroxychloroquine was touted as one thing of a miracle treatment by its proponents — notably US President Donald Trump — regardless of an absence of proof that it labored.
Amongst scientists, controversial French professor Didier Raoult argued vociferously in favour of the drug.
Hydroxychloroquine was on the centre of an instructional scandal, when the distinguished medical journal the Lancet needed to retract a research that recommended damaging results from the drug, after considerations have been raised concerning the underlying information.
The retraction of analysis vital of hydroxychloroquine solely served to galvanise supporters of the drug.
However research after research has proven that it’s not efficient in opposition to COVID-19 together with the British trial Restoration, whose outcomes have been printed within the New England Journal of Medication in October.
Used in opposition to HIV, the virus that causes AIDS, this one-two antiviral punch has proven to be ineffective at treating COVID-19 in hospital settings, in line with the Restoration trial, which printed its ends in the Lancet in October.
Nonetheless beneath investigation
Scientists hope this immunosuppressant, at the moment used in opposition to rheumatoid arthritis, will be capable of forestall probably lethal irritation in critical circumstances.
To this point, nevertheless, research haven’t but offered a definitive reply.
Researchers from Imperial Faculty London introduced on November 19 that tocilizumab gave the impression to be having a useful impact, in line with preliminary outcomes from their medical trial.
The larger-scale Restoration trial might reveal extra within the coming weeks.
When the physique fights off viruses akin to SARS-CoV-2 it develops antibodies — proteins which can be programmed to focus on particular pathogens.
These anti-bodies might be synthesised in a lab and will in idea be given to sufferers sick with COVID-19 to spice up their very own pure immune response.
Trump obtained this nonetheless experimental therapy, manufactured by the American biotechnology firm Regeneron when he was hospitalised with the virus.
This therapy, and one of many similar sort manufactured by Eli Lilly, have obtained authorization for emergency use within the US.
However their effectiveness continues to be evaluated, with the Regeneron therapy included within the Restoration trial.
Plasma taken from the blood of recovered sufferers confirmed some early promise when given intravenously to individuals sick with COVID-19 .
It has already proven to assist pace restoration from Ebola in addition to SARS, which is brought on by the identical household of pathogens because the novel coronavirus .
Restoration has an ongoing medical trial for plasma therapy.