Indian health authorities are all set to review the Covid-19 protocol followed at present after interim results from a World Health Organization (WHO) trial found four of the commonly used drugs provide little or no benefit in reducing fatalities in hospitalised patients. These drugs include remdesivir, malaria drug hydroxychloroquine (HCQ), an anti-HIV combination of lopinavir and ritonavir, and the immunomodulator interferon.
A senior official in the Union ministry of health and family welfare said the protocol will be reviewed in the next joint task force meeting headed by Dr VK Paul, member (health), Niti Aayog, and director general, Indian Council of Medical Research (ICMR), Dr Balram Bhargava. Speaking in an interview, Dr Bhargava said, “Yes, we will be revisiting the clinical management protocol in the light of new evidence before us.”
The WHO's Solidarity Trial casts doubt on the effectiveness of these drugs that covered 405 hospitals in 30 countries. The data was randomised and came from 11,266 adults being treated for Covid-19. In all 2,750 of them were allocated remdesivir, 954 HCQ, 1,411 lopinavir, 651 interferon plus lopinavir, 1,412 only interferon, and 4,088 were on no study drug. India also participated in the trials and tested the four drugs. According to ICMR, which coordinated the trials in the country, there were 26 actively randomising sites with 937 participants as of October 15, 2020.
The ICMR said in a statement, “The interim results show that no study drug definitely reduced mortality or initiation of ventilation in hospitalized Covid-19 patients.”
Study co-author Dr K Srinath Reddy, founder, Public Health Foundation of India, said, “The objective of this trial was to see whether these drugs work or not. We have found the answer that these do not work, and it was crucial to get this answer. Then there are certain soft endpoints like if there are any particular subsets that benefit more; like Americans are saying that it cut short the recovery time etc., which we will get to know as the trial is ongoing.”
He added, “For drugs such as interferon, the trial has shown that it is almost on the verge of doing harm to hospitalized patients, so there is no point in continuing with this arm. We could now try other available drugs that may also be cheaper.” WHO hinted that it would make changes to its trial arm. It said in its statement, “Newer antiviral drugs, immunomodulators and anti-SARS COV-2 monoclonal antibodies are now being considered for evaluation.”