COVID-19 treatment: Study shows HIV drug combo lopinavir-ritonavir not effective for hospitalised patients

New Delhi, 7-Oct-2020

A major study has found that the HIV drug combination of lopinavir-ritonavir does not benefit patients hospitalised with COVID-19, the disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in China in late 2019 from a zoonotic source. While scientists had hoped that antiviral therapy would help in the fight against COVID-19, findings from the RECOVERY trial showed that it does not, like it does for HIV. The study, published in the medical journal The Lancet showed that the HIV drug combo lopinavir-ritonavir treatment does not significantly reduce deaths, length of hospital stay, or the risk of needing intensive care or dying in patients admitted to hospital with COVID-19.

Lopinavir-ritonavir therapy does not benefit COVID-19 patients
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In this randomised, controlled, open-label, platform trial, the researchers used a range of possible treatments, including lopinavir-ritonavir combo, to assess whether the therapies can improve outcomes in patients admitted to hospital with COVID-19. According to the study, about 1616 patients were randomly allocated to get lopinavir-ritonavir and 3424 patients to receive usual care. Overall, 374 (23 per cent) patients allocated to lopinavir-ritonavir and 767 (22 per cent) patients allocated to usual care died within 28 days. The researchers said lopinavir-ritonavir was not linked with reductions in 28-day mortality, duration of hospital stay, or risk of progressing to invasive mechanical ventilation or death among hospitalised COVID-19 patients. The researchers concluded that findings from the trial do not support the use of lopinavir-ritonavir for the treatment of patients admitted to the hospital with coronavirus infection. The authors of the study also recommended that clinical guidelines be updated based on the results of the RECOVERY trial, which is underway at 176 UK hospitals. Several clinical care guidelines have recommended lopinavir�ritonavir for the treatment of COVID-19 patients admitted to the hospital. �The result of the RECOVERY trial is clear. When combined with findings from an earlier, smaller trial and with the WHO interim results, this provides strong evidence that lopinavir-ritonavir is not an effective treatment for patients hospitalised with COVID-19,� said Professor Peter Horby, from the Nuffield Department of Medicine at the University of Oxford, UK, co-Chief Investigator of the RECOVERY trial. The drug combination lopinavir-ritonavir has been proposed as an antiviral treatment for COVID-19, on the basis of in vitro activity, preclinical studies, and observational studies. �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,� said Professor Martin Landray from the Nuffield Department of Population Health at the University of Oxford, UK, who co-leads the RECOVERY trial. �Since our preliminary results were made public on June 29, 2020, the World Health Organization has halted lopinavir-ritonavir treatment groups involved in its SOLIDARITY trial and reported that their interim results are in line with those presented here.� �The result from the RECOVERY trial is clear. When combined with findings from an earlier, smaller trial and with the WHO interim results, this provides strong evidence that lopinavir-ritonavir is not an effective treatment for patients hospitalised with COVID-19,� said Professor Peter Horby, from the Nuffield Department of Medicine at the University of Oxford, UK, co-Chief Investigator of the RECOVERY trial. The study authors noted that the RECOVERY trial is the first large-scale randomized clinical trial to report the effects of lopinavir-ritonavir in patients admitted to hospital with COVID-19.