London, Oct 6 : The drug combination lopinavir-ritonavir is not an effective treatment for patients admitted to hospital with Covid-19, according to the results of a study published in the journal The Lancet.
Many clinical care guidelines have recommended lopinavir-ritonavir — an antiviral medication approved to treat HIV/AIDS — for the treatment of patients hospitalised with Covid-19. However, these guidelines should now be updated, the research team said.
The Randomised Evaluation of Covid-19 therapy (RECOVERY) trial, underway at 176 UK hospitals, is the first large-scale randomised clinical trial to report the effects of lopinavir-ritonavir in patients admitted to hospital with Covid-19.
“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 study author Martin Landray from the University of Oxford, UK.
“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,” Landray added.
According to the study, 1,616 patients in the RECOVERY trial were randomised to receive lopinavir-ritonavir while 3,424 patients received usual care alone.
Those on lopinavir-ritonavir received 400 mg of lopinavir and 100 mg of ritonavir by mouth every 12 hours for 10 days or until discharge, if sooner. The primary outcome was 28-day all-cause mortality.
Findings from the trial indicate that using lopinavir-ritonavir to treat patients hospitalised with Covid-19 does not reduce deaths within 28 days of treatment beginning.
The study revealed that 23 per cent who received lopinavir-ritonavir and 22 per cent allocated to usual care died within 28 days.
“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 study author Peter Horby from the University of Oxford.
“Whilst it is disappointing that there was no significant benefit from lopinavir-ritonavir for patients in the hospital, these findings have allowed us to focus our efforts on other promising treatments, and have informed the way in which individual patients are treated,” Horby noted.