Doctors are being urged to enrol patients in clinical trials testing the most promising potential treatments for covid-19.

The UK is running three key national trials to gather evidence on drugs which may work, from managing the illness in the community through to hospitals and intensive care units.

A letter has been issued by Chief Medical Officers across the UK asking that “every effort” is made to enrol patients in the trials, which are being run as “simply as they can to reduce the burden on the NHS.”

It emphasises the need to gather “reliable evidence” as there are “no proven treatments” yet for the virus.

“The results are essential to the future treatment of UK and global patients. We will ensure important results are disseminated rapidly to improve practice,” the letter adds.

“The faster that patients are recruited, the sooner we will get reliable results.”

One of the national trials will look at how best to treat people in the community to halt the progress of the disease and reduce the need for hospital admission.

The PRINCIPLE trial aims to evaluate potential treatments as soon as they become available, with hydroxychloroquine the first drug to be assessed.

The drug – which US President Donald Trump has been pushing as a treatment – has been used for years for conditions such as malaria and arthritis but is not currently used to treat infections like covid-19.

Another trial will look at how different drugs might help people recover from covid-19 after being admitted to hospital.

It will test a number of suggested treatments including Lopinavir-Ritonavir, commonly used to treat HIV and low-dose Dexamethasone, a steroid which is used typically to reduce inflammation in a number of conditions.

The RECOVERY trial will also look at hydroxychloroquine for hospital patients.

The final trial will focus on critically ill patients, with participants given a drug from one or more categories of treatment.

This differs from traditional clinical trials, where selected patients receive one treatment from a shortlist of one or two alternatives. It means different treatments can be tested at the same time.

The categories in the REMAP-CAP trial include treatment with a class of antibiotics known as macrolide, evaluation of different ways of using steroids, antiviral therapies and immune modulation therapy – normally used to boost the body’s immune response to cancer.

There are also a range of other urgent research studies being undertaken on covid-19, looking at different areas such as pregnancy and the development of a vaccine.

The letter from the CMOs also urges doctors not to prescribe ‘off-licence’ treatments if a patient can take part in one of the studies.

“Use of treatments outside of a trial, where participation was possible, is a wasted opportunity to create information that will benefit others,” it states.

“The evidence will be used to inform treatment decisions and benefit patients in the immediate future.”

 

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