Good news about triple antiviral therapies - Printable Version
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Good news about triple antiviral therapies - BostonCard - 05-11-2020
For patients with mild to moderate disease, a "triple therapy" consisting of ribavirin (a generalized antiviral used mostly for RSV), ritonavir/lopinavir (an HIV antiviral), and interferon (a substance the body produces to fight viruses) beat ritonavir/lopinavir alone in reducing viral shedding, speeding up recovery, and speeding discharge from the hospital. Nobody in this study died (which is surprising), so they couldn't look for a mortality benefit.
https://www.nytimes.com/2020/05/08/health/coronavirus-drug-treatment.html
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31042-4/fulltext
The good news is that it is randomized trial, and the effect was quite significant (a reduction in hospitalization of 5.5 days, which is actually a bigger effect than the remdisivir study). On the other hand, it was an open-label study (so everyone knew which arm patients were on), and it was smaller than the remdisivir study, so the effect sizes are probably overstated (an underpowered study will show wider confidence intervals than a well-powered study, so if a given study happens by chance to be positive, it will demonstrate a larger effect, since a moderate effect would not be statistically significant and would be considered "negative").
BC
RE: Good news about triple antiviral therapies - M T - 05-11-2020
Good to see. Oral drugs & injections, so these treatments (when validated & approved) could be done outside hospitals, right? I was a little surprised that it was an average of 5 days after symptoms showed that treatment started. I'd hope that a quicker start would do even better. ("no significant differences between the treatment groups were measured in these outcomes in the 51 patients who were treated 7 days or more after symptom onset")
"Public health ordinance in Hong Kong required all patients tested positive for COVID-19 be admitted to hospital." They chose patients from those admitted (screened 80% of all Hong Kong patients). So these are likely primarily (80%) mild cases, but they indicate 75% have abnormal chest x-rays. Still, out of 127 cases, it would be unusual to not have any deaths. The two groups matched quite well, but the control group had somewhat fewer comorbidities (good).
RE: Good news about triple antiviral therapies - Snorlax94 - 05-11-2020
Stanford is also testing repurposing peginterferon lambda-1a which a rich donor, who would like people to test the drug so he can go out again, says “If I were sick, this drug would be my first choice.”
If you or a family member teated positive and were early stage, which would you pick: remdesivir, peginterferon lambda-1a, the ritonavir/lopinavir/interferon triple therapy, or nothing?