Lopinavir/ritonavir, marketed under the brand names Kaletra and Aluvia, is an anti-HIV medicine also being trialled
An HIV drug earmarked as a potential coronavirus treatment does not improve the condition of patients with the infection, a major British trial has found.
Oxford University scientists pulled lopinavir/ritonavir from the RECOVERY Trial today after results showed it had no benefit on people hospitalised with the virus.
The anti-HIV drug, marketed as Kaletra and Aluvia, has been trialled in hospitals around the world to treat the disease — despite no evidence it works.
It was earmarked early on in the pandemic because it interferes with the same enzymes involved in the replication of Covid-19 inside the body.
Professor Peter Horby, who is heading RECOVERY, told the House of Lords Science and Technology Committee today that results on lopinavir/ritonavir were ‘pretty clear’.
He said: ‘We’ve just looked at the results [on lopinavir/ritonavir] and shown that it’s not effective.
‘That’s another drug that has been recommended in national guidelines in many countries, we’ve shown pretty clearly now that it doesn’t work either.’
WHAT IS LOPINAVIR/ RITONAVIR?
The combination of lopinavir and ritonavir is used on HIV patients to prevent the virus developing into AIDS.
Lopinavir and ritonavir are in a class of medications called protease inhibitors.
Protease inhibitors work by sticking to an enzyme on a virus which is vital to the virus reproducing.
By doing this it blocks the process the virus would normally use to clone itself and spread the infection further.
When lopinavir and ritonavir are taken together, ritonavir also helps to increase the amount of lopinavir in the body so that the medication will have a greater effect.
The combination comes as a tablet or a solution. It is usually taken twice a day.
HIV patients were prescribed either Kaltra or ritonavir alone around 1,400 times in 2018.
Side effects include nausea, vomiting, stomach upset, gas, headache, and trouble sleeping.
Lopinavir/ritonavir was given to three groups of coronavirus patients with varying degrees of illness – those on ventilators, patients needing oxygen and people who had mild symptoms.
The results were then compared against a control group receiving standard care, which included painkillers and, in some cases, antibiotics.
The full results have not been released but Professor Horby said the team were compiling the data to be sent out later today.
It makes lopinavir/ritonavir the second drug to be ditched from the trial, after promising malaria drug hydroxychloroquine was removed on June 5.
The antimalarial was similarly found to have no effect on any of the groups of coronavirus patients.
But the RECOVERY trial has also been responsible for the biggest breakthrough yet in the global coronavirus fight, after proving a cheap steroid reduced death in very ill sufferers.
Dexamethasone was shown to save up to 35 per cent of patients relying on ventilators – the most dangerously ill – and reduce the odds of death by a fifth for all patients needing oxygen at any point.
More than 11,800 Covid patients have been taking part in the Randomised Evaluation of COV-id19 thERapY (RECOVERY) trial at hundreds of hospitals around the UK.
Only three treatments remain in the trial after today’s announcement – azithromycin, a commonly used antibiotic; tocilizumab, an anti-inflammatory given by injection; and convalescent plasma therapy, which sees blood of survivors injected into patients struggling to shake the disease.
Professor Horby said the team were looking to add more drugs as the trial moves into the winter.
It comes after dexamethasone, a cheap steroid that has been around for decades, became the first medicine proven to reduce the death rate among hospitalised patients.
Announcing the news on June 16, Professor Horby said that treating eight people with the drug could save one life and cost just £40 in total.
It could save up to 35 per cent of patients relying on ventilators – the most dangerously ill – and reduce the odds of death by a fifth for all patients needing oxygen at any point.
The steroid prevents the release of substances in the body that cause inflammation, a nasty Covid-19 complication that makes breathing difficult. In seriously unwell patients, the lungs become so inflamed they struggle to work.
Dexamethasone is now the second drug available in the NHS arsenal to treat Covid-19, after Ebola medicine remdesivir was last month given the green light in another scientific breakthrough.