Ebola therapies: an unconventionally calculated risk

Fallah, Mosoka; Skrip, Laura

doi:10.1016/s0140-6736(19)30160-6

Cited by 4 publications

(2 citation statements)

References 11 publications

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“…The essential consideration is how the resulting data can add to previous trials and influence the approach to trials in future epidemics. For example, research during the 2013-2015 Ebola epidemic enabled progress on therapeutic agents 70 that are now being trialled in the ongoing outbreak in DRC 71 . Scientific progress during and between epidemics must be matched by other workstreams, such as the preparation of supply chain logistics and communication with at-risk populations.…”

Section: Reviewmentioning

confidence: 99%

A new twenty-first century science for effective epidemic response

Bedford

Farrar²,

Ihekweazu

et al. 2019

Nature

253

204

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With rapidly changing ecology, urbanization, climate change, increased travel and fragile public health systems, epidemics will become more frequent, more complex and harder to prevent and contain. Here we argue that our concept of epidemics must evolve from crisis response during discrete outbreaks to an integrated cycle of preparation, response and recovery. This is an opportunity to combine knowledge and skills from all over the world-especially at-risk and affected communities. Many disciplines need to be integrated, including not only epidemiology but also social sciences, research and development, diplomacy, logistics and crisis management. This requires a new approach to training tomorrow's leaders in epidemic prevention and response.

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Section: Reviewmentioning

confidence: 99%

A new twenty-first century science for effective epidemic response

Bedford

Farrar²,

Ihekweazu

et al. 2019

Nature

253

204

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“…Since the Ebola outbreak in West Africa and subsequent outbreaks in the Democratic Republic of Congo, clinical trials of investigative drugs have been fully integrated in the epidemic response. [5][6][7] The COVID-19 pandemic is unique because of its scale, the speed of its spread, the lack of pre-existing scientific data and the importance of media and scientific coverage. 2 To encourage the development of clinical trials that test therapeutics against SARS-CoV-2, the WHO has suggested a number of candidate antiviral agents that have to be tested in clinical trials.…”

Section: Why Is This Review Needed?mentioning

confidence: 99%

A brief review of antiviral drugs evaluated in registered clinical trials for COVID-19

Belhadi

Peiffer-Smadja

Lescure

et al. 2020

Preprint

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BackgroundAlthough a number of antiviral agents have been evaluated for coronaviruses there are no approved drugs available. To provide an overview of the landscape of therapeutic research for COVID-19, we conducted a review of registered clinical trials. MethodsA review of currently registered clinical trials was performed on registries, including the Chinese (chictr.org.cn) and US (clinicaltrials.gov) databases to identify relevant studies up to March, 7 th 2020. FindingsOut of the 353 studies identified, 115 clinical trials were selected for data extraction. Phase IV trials were the most commonly reported study type (n=27, 23%). However, 62 trials (54%) did not describe the phase of the study. Eighty percent (n=92) of the trials were randomized with parallel assignment and the median number of planned inclusions was 63 (IQR, 36-120). Open-label studies were the most frequent (46%) followed by double-blind (13%) and single blind studies (10%). The most frequently assessed therapies were: stem cells therapy (n=23 trials), lopinavir/ritonavir (n=15), chloroquine (n=11), umifenovir (n=7), hydroxychloroquine (n=7), plasma treatment (n=7), favipiravir (n=7), methylprednisolone (n=5), and remdesivir (n=5). Remdesivir was tested in 5 trials with a median of 400 (IQR, 394-453) planned inclusions per trial, while stem cells therapy was tested in 23 trials, but had a median of 40 (IQR, 23-60) planned inclusions per trial. Lopinavir/ritonavir was associated with the highest total number of planned inclusions (2606) followed by remdesivir (2155). Only 52% of the clinical trials reported the treatment dose (n=60) and only 34% (n=39) the duration. The primary outcome was clinical in 76 studies (66%), virological in 27 (23%); radiological in 9 (8%) or immunological in three studies (3%). InterpretationNumerous clinical trials have been registered since the beginning of the COVID-19 outbreak, however, a number of information regarding drugs or trial design were lacking.

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