More than 100 covid-19 clinical trials carried out "one stage competition" for multiple therapies

Li Xia Novel coronavirus (SARS-CoV-2) was launched in China in February 15th, and Nature magazine published a report entitled "More than 80 clinical trials launch to test coronavirus treatments" As of February 17, China clinical trial registration center alone has registered more than 100 intervention studies on sars-cov-2 infection (covid-19) According to the nature article, the clinical trials of publicly registered investigational drugs for the safety and efficacy of covid-19 are increasing every day There are not only unlisted new drugs (such as remdesivir), but also traditional Chinese medicines (such as Shuanghuanglian) that have been used for many years These drugs / therapies have varying amounts of evidence to support their efficacy The mechanism of action of the anti HIV drug lopinavir / ritonavir is to block the enzymes needed for virus replication In animal studies, lopinavir / ritonavir has been shown to reduce the level of coronaviruses that cause SARS and mers As of February 17, the website of China clinical trial registration center has registered 9 clinical trials including lopinavir / ritonavir for covid-19 (below) However, novel coronavirus infection pneumonia expert group member Hu Bijie said in February 17th that the clinical results of RP and ritonavir against the virus were not obvious, and no longer recommended The nucleoside analogue, remdesivir, has also successfully antagonized the coronavirus in animal models In addition, it has been reported that one patient in the United States survived from sars-cov-2 infection after being treated with remdesivir In early February, China launched two placebo-controlled trials (nct04257656 and nct04252664) on remdesivir, and plans to recruit 760 patients with covid-19 Jiang Shibo, a virologist at Fudan University, said the studies should be completed by the end of April Remdesivir may be approved in China as early as may, but by then, the epidemic may have passed Chloroquine is a widely used anti malarial and autoimmune drug A recent study confirmed that chloroquine can kill sars-cov-2 in vitro At present, a large number of trials have been launched to investigate the safety and efficacy of chloroquine in the treatment of covid-19 Some relevant information about the trials is shown in the table below It is worth mentioning that sun Yanrong, deputy director of the biological center of the Ministry of science and technology, said at the press conference of the joint prevention and control mechanism of the State Council on February 17 in response to a reporter's question that in clinical practice, he saw very definitely the efficacy of chloroquine phosphate, no matter from the rate of severity, the phenomenon of fever reduction or the time of image improvement of the lung, the time and rate of virus nucleic acid turning negative, and the shortened course of disease A series of indicators, the drug group is better than the control group In addition, no serious adverse reactions related to drugs have been found in more than 100 patients Based on these findings novel coronavirus pneumonia is believed to be effective in treating new crown pneumonia, based on the results of previous clinical studies Based on the urgent need of clinical treatment, experts unanimously recommended that "chloroquine phosphate should be included in the new version of the diagnosis and treatment guidelines as soon as possible, and the clinical trial scope should be expanded." Glucocorticoid anti-covid-19 was controversial before three British scientists pointed out in the lancet on February 7 that the current clinical evidence does not support the use of glucocorticoid in the treatment of lung injury caused by the new coronavirus; then, on February 11, doctors of China's first-line treatment of covid-19 wrote in the lancet that they have different views At present, there are also clinical trials involving glucocorticoid treatment of covid-19 (such as chictr2000029656, chictr2000029386) in progress Yazdan yazdanpanah, a French epidemiologist, said that if the epidemic continues to spread, clinical researchers around the world will need the results of these trials A randomized, controlled clinical trial (chictr2000029757) of plasma from convalescent patients is also under way, and 300 patients are planned to be recruited In the convalescent period, the plasma treatment of convalescent patients, in fact, is to use the virus specific antibody of a certain titer in the plasma of convalescent patients to reduce the virus content in patients, so as to achieve the treatment expectation In the past few decades, this kind of therapy has achieved some success in treating other viral infections Novel coronavirus pneumonia (COVID-19) is also registered in the China clinical trial registry website (ChiCTR2000029818) Several clinical studies of stem cell therapy for covid-19 have also been registered on the website of China clinical trial registration center In one of the studies, the team from the First Affiliated Hospital of Zhejiang University Medical College will give 28 patients an intravenous infusion of palace blood stem cell preparation (below) According to experts from the Ministry of science and technology, stem cell therapy can inhibit the over activation of the immune system, promote the endogenous repair by improving the microenvironment, inhibit the progress of acute lung inflammation, and alleviate the symptoms of respiratory distress After strict pre clinical safety, effectiveness evaluation, and strict quality inspection, stem cell products in accordance with the current norms of stem cell clinical application and drug clinical trials under the premise of a number of severe patients were treated, but also initially showed safe and effective So far, however, there is little evidence that stem cells can clear away coronavirus infection, according to nature At present, there are many simultaneous interpreting of clinical trials for different traditional Chinese medicines in the treatment of COVID-19 (such as ChiCTR2000029763, ChiCTR2000029769, ChiCTR2000029819, ChiCTR2000029822, ChiCTR2000029855, etc.) We expect to recruit more than 2000 patients Novel coronavirus pneumonia (COVID-19) is a randomized, open, parallel controlled, multicenter clinical trial to evaluate the efficacy and safety of Shuanghuanglian oral liquid in the treatment of new coronavirus pneumonia (SARS) Novel coronavirus pneumonia (COVID-19) was also registered in the First Affiliated Hospital of Zhengzhou University, in addition to the above mentioned treatment mentioned in Nature (ChiCTR2000029849) 60 patients were enrolled in the trial plan Patients in the observation group received "regulation of intestinal flora drug treatment + routine treatment", while patients in the control group received "routine treatment" Nature reports that who is working with Chinese scientists to standardize the design of all research, including research on traditional Chinese medicine Soumya Swaminathan, who's chief scientist, stressed that all efforts could be in vain if these clinical trials were not designed with strict research parameters.