Antiviral hyped as potential Covid treatment "ineffective", finds major study

An antiviral drug used to treat HIV and earmarked as a potential Covid-19 treatment is “ineffective” in treating Covid-19, a major study has indicated.
Lopinavir-ritonavir showed “no beneficial effect” in hospitalised patients not on ventilators, according to the University of Oxford’s Recovery trial – the world’s largest randomised clinical trial (RCT) of potential Covid-19 treatments.

“The data convincingly rule out any meaningful mortality benefit of lopinavir-ritonavir in the hospitalised Covid-19 patients,” it said.

Many countries which currently recommend the drug should revise their guidelines in the wake of the results, experts said, as they pulled the medication from the trial.

In the study, a total of 1,596 patients were randomised to receive the drug and were compared with 3,376 patients randomised to receive standard hospital care.

Of these patients, 4% required invasive mechanical ventilation when they entered the trial, 70% required oxygen alone, and 26% did not require any respiratory intervention.

The researchers found that there was also no evidence of beneficial effects on the risk of progression to mechanical ventilation or length of hospital stay. “The results showed “no significant difference in the primary endpoint of 28-day mortality” (22.1% lopinavir-ritonavir v 21.3% usual care), the Recovery trial said.

The trial researchers added: “The results were consistent in different subgroups of patients.

Martin Landray, professor of medicine and epidemiology at the Nuffield Department of Population Health, University of Oxford, and deputy chief investigator of the Recovery trial, said: “These are clear results and once again emphasise the value of large randomised clinical trials in differentiating drugs we hope work from treatments we know do work.

“In many countries, current guidelines recommend lopinavir-ritonavir as a treatment for Covid-19. The results from this trial together with those from other large randomised trials, should inform revisions to those guidelines and changes to the way individual patients are treated,” Landray said.