Coronavirus cure: What progress are we making on treatments?

Trials around the world are attempting to identify treatments for people with severe Covid-19.

By James GallagherHealth and science correspondent

• 2 September 2020
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The first drugs that do make a difference are now being identified.

What work is being done to find treatments?

More than 150 different drugs are being researched in different countries. Most are existing drugs that are being trialled against the virus.

• The UK is running the the world's largest clinical trial, called Recovery, with more than 12,000 patients taking part - it is one of the few trials to have given a definitive view on which drugs do and do not work
• The World Health Organization (WHO) is running the the Solidarity trial to assess promising treatments in countries around the world
• Multiple pharmaceutical companies are running trials of their own drugs

There are three broad approaches being investigated:

• Antiviral drugs that directly affect the coronavirus's ability to thrive inside the body
• Drugs that calm the immune system (severe Covid-19 is caused by patients' immune systems overreacting and damaging the body)
• Antibodies that can target the virus, taken from either survivors' blood plasma or made in a lab

It is possible that different drugs will work better at different stages - such as anti-virals at the beginning and immune drugs in late-stage diseases. Combinations of therapies will also be investigated.

The only life-saving drugs

Of all the drugs being trialled, only steroids have been proven to save lives and the discovery has been a a significant breakthrough in the fight against coronavirus.

The UK's Recovery trial showed the steroid dexamethasone cut the risk of death by a third for patients on ventilators and by a fifth for those on oxygen.

And further data suggests another steroid, hydrocortisone, is equally effective too.

Both calm down inflammation (part of the immune response) in the body, which can become damaging in severe cases.

Crucially it is also cheap which means it could be used all around the world.

However, the drug does not work on people with milder symptoms.

• What is dexamethasone and how does it work?

What other drugs look promising?

Remdesivir is an antiviral drug that was originally developed to treat Ebola.

Clinical trials of more than 1,000 people found it cut the duration of symptoms from 15 days to 11. It has not been shown to save lives, although studies are still continuing.

However, the US has bought almost all of the supply, with the manufacturer Gilead also donating some to South Korea.

Interferon beta is a protein that the body normally makes to dampen down inflammation. It is used as a treatment for multiple sclerosis.

The UK company Synairgen is delivering the drug directly to Covid-19 patients' lungs using a nebuliser.

Initial findings suggest the treatment cut the odds of a patient in hospital developing severe disease, but larger clinical trials are now needed.

What do I need to know about the coronavirus?

• SOCIAL DISTANCING: What are the rules now?
• SUPPORT BUBBLES: What are they and who can be in yours?
• FACE MASKS: When do I need to wear one?
• SCHOOLS: What will happen if children catch coronavirus?
• TESTING: What tests are available?

Can HIV drugs treat coronavirus?

No.

A pair of drugs called lopinavir and ritonavir are antiviral drugs that stop HIV from replicating.

There has been much talk and even early laboratory studies hinting they could be effective against coronavirus too.

However, the UK's Recovery trial showed they were ineffective and the WHO has also pulled the drugs from their Solidarity trial.

Can malaria drugs stop coronavirus?

It's another no.

Chloroquine, and the related drug, hydroxychloroquine, may have antiviral and immune-calming properties.

The drugs were thrust into the spotlight as potential coronavirus therapies, largely because of claims made by President Trump, and because early laboratory tests showed they could inhibit the coronavirus.

However, the UK's Recovery trial found that hydroxychloroquine does not work as a treatment for Covid-19 and the WHO has stopped trialling the drug.

Media captionEpidemic v pandemic: What's the difference?

Can survivors' blood treat coronavirus?

People who survive an infection should have antibodies in their blood that can attack the virus.

Blood plasma (the part which contains the antibodies) can be extracted from those who have recovered and then given to sick patients as "convalescent plasma".

It is hoped transfusing seriously-ill patients with the plasma can give struggling immune systems a helping hand.

This therapy is now being tested in people in the UK and the US, among other countries. Two separate UK trials are currently running.

The US Food and Drug Administration (FDA) has given emergency authorisation for the use of plasma to treat coronavirus patients based on promising results from early trials - although some experts say it's too soon to know how effective the treatment is.

• 'Right thing' to be part of Covid-19 plasma trial
• 'Men make better coronavirus plasma donors'

Media captionAnn "felt so well" after being given plasma from patients who recovered from Covid-19

How long until we have a cure?

We may never get a "cure" for coronavirus. We don't have one for flu or the common cold or other similar infections.

However, there is now one treatment that works and others that look promising.

Doctors are testing drugs that have already been developed and are known to be safe enough to use, so more trial results can be expected relatively soon.

This contrasts with trials for vaccines (which protect against infection rather than treating it) where researchers are starting from scratch.

Some completely new experimental coronavirus drugs are also being tested in the laboratory, but are not yet ready for human tests.

Why do we need a treatment?

The most obvious reason for wanting a treatment is it will save lives, but it could also allow the lifting of restrictions such as lockdowns and social distancing.

Having an effective treatment would, in essence, make coronavirus a milder disease.

If it stopped people who were admitted to hospital from needing ventilation, then there would be less risk of intensive care units being overwhelmed, so controls on people's lives would not need to be as strict.

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Related Topics

• Immune system
• Coronavirus pandemic
• Flu
• Medical research

https://www.bbc.com/news/health-52354520

More on this story

• Remdesivir: Drug has 'clear-cut' power to fight coronavirus

  29 April 2020
• Coronavirus: How long does it take to recover?

  1 May 2020
• Coronavirus vaccine: When will we have one?

  4 September 2020
• Coronavirus: What it does to the body

  14 March 2020

Treatment drugs recommended so far:

• FDA approves remdesivir despite doubts about effectiveness (23 Oct 2020)
• Covid: Remdesivir 'has little or no effect' on survival, says WHO (16 Oct 2020)
• Coronavirus cure: What progress are we making on treatments? (this article)
• Important Updates of COVID19 Treatment - MUST READ 
• Coronavirus: what-drug-treatment-works
• Dexamethasone proves first life-saving drug - Coronavirus
• UK authorises anti-viral drug remdesivir - Coronavirus (see also articles above of 23 Oct and 16 Oct 2020)
• Ibuprofen tested as a treatment - Coronavirus
• Coronavirus: Protein treatment trial 'a breakthrough'
• Convalescent plasma therapy for severe SARS-CoV-2 - Graphic News

SEE ALSO:

• Can Ivermectin Help Prevent COVID-19 Deaths? - MUST READ

Diabetes drug Metformin offers hope of new treatment for multiple sclerosis

Trial using rats showed the drug metformin repaired nerve damage caused by the disease

Ian Sample Science editor

 @iansample

Wed 2 Oct 2019 16.05 BST

Scientists have raised hopes of a new treatment for multiple sclerosis after animal studies showed a common diabetes drug can repair nerve damage caused by the disease.

The effect of the drug was so striking that doctors in Cambridge are now planning a clinical trial of MS patients next year.

If the treatment works as expected, it could potentially halt the progression of the disease and even allow patients to recover from some of the disabilities that typically develop as the condition worsens.

“It’s always a leap in the dark when you go from lab experiments to humans, but the data is as strong and as compelling as it is ever likely to get,” said Robin Franklin, a professor of stem cell medicine at Cambridge University. “I am very optimistic that this is going to work.”

MS affects one in 600 people in the UK, where about 100,000 people live with the condition. The disease is caused by the immune system mistakenly attacking a fatty coating called myelin that wraps around nerves in the brain and spinal cord. Without myelin, messages sent along nerves slow down, are disrupted, or fail to get through at all.

In the early stages, MS can cause eye problems such as pain and temporary loss of vision, but also difficulties with balance, dizziness, muscle spasms and tremors. In the longer term, nerves that have been stripped of their myelin degenerate, and it is the loss of these that leads to disability.

Working with researchers in Australia, the Cambridge team administered the diabetes drug metformin to rats for three months before they had an injection that stripped myelin off some of the nerves in the brain. The rats continued to receive the drug for three more weeks afterwards.

The treatment had a profound effect. Compared with animals that went without, those on metformin had a near complete recovery of the damaged myelin. “It is utterly unambiguous and very spectacular,” Franklin said. The same result was seen in animals that went without food on alternate days for six months. Dramatically reducing calorie intake has been shown to increase the regenerative capabilities of the body.

Writing in the journal Cell Stem Cell, the scientists describe further experiments that show how both fasting and metformin rejuvenate stem cells in the brain. Once in this more youthful state, they go on to develop into myelin-producing cells called oligodendrocytes. These in turn restore the myelin that MS destroys.

The scientists hope the drug will at least slow the progression of the disease. But a more optimistic possibility is to stop further neurological damage completely. If doctors can achieve that, the patient’s nervous system may be able to rewire itself enough to recover from some of the disabilities.

“My own view is that this is most likely to benefit individuals who are about to switch from relapsing-remitting MS into secondary progressive disease,” Franklin said. “But if you have an effect with a regenerative medicine, you can give it at any stage of the disease and it will be helpful.”

Anna Williams, a professor of regenerative neurology at the University of Edinburgh MRC Centre for Regenerative Medicine, who was not involved in the study, said: “We know that repair generally gets worse with age, but this is exciting as it suggests that myelin repair in the brain and spinal cord in aged adult rodents can be improved. If this relatively simple, cheap and available drug can rejuvenate myelin repair in humans as well, then this may be really helpful in neurodegenerative diseases such as multiple sclerosis where efficiently restoring myelin will help avoid disability.”

Susan Kohlhaas, the director of research at the MS Society, which funded the work, said: “We can see a future where nobody needs to worry about MS getting worse, or eventually needing a wheelchair, but for this to happen we need treatments that repair myelin. This research demonstrates myelin repair therapies are within our grasp, and we’re closer than ever to finding treatments for everyone living with MS.”

https://www.theguardian.com/science/2019/oct/02/diabetes-drug-offers-hope-new-treatment-multiple-sclerosis

Also: Hope for multiple sclerosis patients as scientists reveal type 2 diabetes drug metformin 'can reverse nerve damage caused by MS in rats in three months'