Coronavirus: The latest in drug treatment and vaccine development

Scientists around the world are racing to find novel ways to treat, mitigate or prevent infection from the novel coronavirus.

The response has been especially rapid as the virus has spread unchecked across the globe. Still, any treatments are a long way from being proven both effective and safe, and most certainly won’t come in time to address the current pandemic.

According to some of the top infectious disease experts in the world, even on an accelerated timeline, a vaccine is still likely 12 to 18 months away — and then the challenge will be producing enough to make it readily available.

There is currently no drug therapy or vaccine widely approved anywhere in the world for COVID-19.

Here are some of the latest developments in the research.

Old drugs, new tricks

May 25: The World Health Organization announces “a temporary pause” on the hydroxychloroquine arm of its global clinical trial called SOLIDARITY, of which Canada is a part, after a paper published last week in the Lancet found no evidence the malaria drug provides any benefit against COVID-19, and people taking it were at higher risk of death and heart problems.

May 21: Nova Scotia-based Appili Therapeutics announces that Health Canada has greenlit its Phase 2 study to evaluate the Japanese flu drug favipiravir as a preventative measure against COVID-19 outbreaks. The study participants will be residents and staff at 16 long-term care homes in Ontario.

May 7: Japan becomes the first country to approve the use of Gilead Sciences Inc.’s remdesivir to treat patients with severe COVID-19, after the U.S. Food and Drug Administration granted the drug an Emergency Use Authorization, a limited type of approval to make a treatment available during public health emergencies.

May 1: Health Canada announces it has authorized the CONCOR-1 clinical study that will involve soliciting donations of blood plasma from recovered COVID-19 patients across the country to see if their antibodies can help treat people who are sick.

April 15: Japan’s Fujifilm announces it is ramping up production of Avigan (favipiravir), a drug approved in 2014 to treat influenza that doesn’t respond to other drugs. It’s produced and distributed at the discretion of the Japanese government and has never been commercially available anywhere in the world. The drug is in Phase 3 clinical trials in Japan, and in other trials in the U.S., Italy and China.

April 9: The University of British Columbia announces that patient enrolment is underway for the Canadian arm of the World Health Organization’s global SOLIDARITY trial, called CATCO (Canadian Trials for COVID). Patients requiring hospitalization for COVID-19 at one of 20 participating hospitals in Canada will be eligible for the trial, which will start by evaluating lopinavir-ritonavir, a combination of antiviral drugs used to treat HIV, compared with “optimized supportive care.” It will later add two other medications for investigation — the antiviral remdesivir and chloroquine, which is used to treat malaria.

April 3: The U.S. Food and Drug Administration announces an “expanded access” program to facilitate wider study of convalescent plasma — that is, injecting the antibody-rich blood plasma of patients who have recovered into patients who are sick — as a potential treatment for COVID-19 patients. The Mayo Clinic is named lead site to co-ordinate the program among dozens of doctors and scientists who initially self-organized to conduct such research.

April 2: Canadian Blood Services (CBS) says it is working with researchers to design a large, national clinical trial on treating the novel coronavirus with convalescent plasma, which CBS and Héma-Québec will be responsible for collecting and supplying to hospitals across the country.

WATCH | Dr. Dana Devine explains how ‘convalescent plasma’ will be collected and used: 

“We think it’s most likely to be effective is when you have a patient who is clearly sick with the virus but whose own immune system hasn’t had a chance to make antibodies yet,” CBS chief scientist Dr. Dana Devine told CBC Radio’s Quirks & Quarks

Convalescent plasma has been used in a small number of COVID-19 patients since the pandemic began, but not in a study comparing those who receive the therapy with those who don’t. 

March 26: Researchers at the University of Manitoba, in conjunction with researchers at the University of Minnesota, University of Alberta and McGill University Health Centre, begin recruiting participants for a series of trials to test whether the malaria drug hydroxychloroquine can reduce the symptoms and severity of COVID-19 and slow its spread.

Long-term use of hydroxychloroquine is known to cause cardiac and eye toxicity, but Dr. Ryan Zarychanski, an associate professor of internal medicine, said the short, five-day trial should be “very safe.”

Experts, including Canada’s chief public health officer, warn that hydroxychloroquine can have serious side-effects. They also say there is a danger that hoarding the medication could hurt the many patients who take it for chronic inflammatory diseases, like lupus and rheumatoid arthritis.

March 25: New York’s Mount Sinai hospital begins treating critically ill COVID-19 patients via plasmapheresis, a century-old therapy that involves removing antibody-rich plasma from blood and returning it to a patient (the same or another) after either treating it or replacing it. In this case, doctors will transfer antibodies from recovered COVID-19 patients into sick ones in the hopes the antibodies will neutralize the disease.

March 24: The Population Health Research Institute in Hamilton announces a study beginning in April to compare therapy using a combination of the antibiotic azithromycin with malaria drug chloroquine versus the usual “standard of care” in COVID-19 patients. The trial will involve some 1,500 participants — a mix of patients who have been hospitalized for the virus and others in the community who have tested positive for it.

March 23: Researchers at the Montreal Heart Institute say they are recruiting up to 6,000 Quebecers over the age of 40 who test positive for the novel coronavirus to study whether colchicine, an anti-inflammatory drug used to treat gout, Behçet’s disease and familial Mediterranean fever, is effective in treating respiratory complications of COVID-19, like lung inflammation, before patients need ventilators or die.

Quebecers who meet the criteria and wish to take part in the study at the Montreal Heart Institute can find out more from their doctor or by calling 1-877-536-6837. (Montreal Heart Institute)

“It’s inexpensive, it’s widely available, and the reason why we think it might very well work is that it’s a powerful anti-inflammatory agent,” Dr. Jean-Claude Tardif, the institute’s research director, said in an interview with CBC Montreal’s Daybreak.

March 18: The World Health Organization announces the SOLIDARITY trial, a co-ordinated international study into potential treatments for COVID-19 that will test and compare four different drugs or combinations of drugs either developed or already licensed for use to treat other illnesses: remdesivir, an antiviral; a combination of two HIV drugs, lopinavir and ritonavir; interferon beta-1a, used to treat multiple sclerosis, with lopinavir and ritonavir; and anti-malaria drug chloroquine. Canada is among the countries participating.

March 11: The World Health Organization declares COVID-19 a pandemic

March 6: Gilead Sciences, the maker of remdesivir, begins two Phase 3 trials of the broad-spectrum antiviral drug: one in patients with “severe disease” and another in patients with “moderate disease.” The studies will be conducted in the U.S., U.K., Italy, Hong Kong, Spain and a number of other countries.

Feb. 21: The U.S. National Institute of Allergy and Infectious Diseases initiates a randomized, double-blind, placebo-controlled trial into remdesivir, which is believed to operate by stopping the virus from replicating. Remdesivir is an investigational drug, meaning it’s not currently approved anywhere to treat any condition. It was developed to treat Ebola but was ultimately unsuccessful. Participants in this trial will be COVID-19 patients with pneumonia and hypoxia. 

Immunizing the herd

May 16: The first Canadian clinical trial for a potential vaccine is set to begin at the Canadian Centre for Vaccinology at Dalhousie University in Halifax, Prime Minister Justin Trudeau announces.

May 12: Canada announces a partnership with Chinese company CanSino Biologics to try and speed up testing and production of its vaccine candidate, which is one of only a handful around the world currently in human trials.

April 30: There are eight vaccine candidates in clinical evaluation, and 94 in preclinical evaluation.

April 21: U.K. Health Secretary Matt Hancock announces that a vaccine candidate being developed by Oxford University will begin human trials on April 23. He said the British government was providing £20 million to the Oxford team to help fund their clinical trials, and a further £22.5 million to researchers at Imperial College London, who are working on another potential vaccine that they have been testing in animals. The Oxford research team said one million doses of its vaccine candidate were already being manufactured, in hopes it turns out to be effective.

April 14: Two global pharmaceutical giants — Paris-based Sanofi and U.K. company GlaxoSmithKline — announce they are joining forces to try and speed up the development of a vaccine, with an optimistic target of the second half of 2021. The companies committed to making any vaccine they develop affordable and accessible.

China’s Ministry of Science and Technology announces CanSino Biologics is beginning the second phase of testing its vaccine candidate, one of only three in the world currently being tested in humans.

April 11: There are three “vaccine candidates” in clinical evaluation, including Inovio’s INO-4800, and 67 more in preclinical evaluation.

April 6: Pennsylvania-based biotechnology firm Inovio Pharmaceuticals administers its first dose of INO-4800, which it developed with funding in part from the Bill and Melinda Gates Foundation. It’s the second vaccine candidate to begin human trials in the U.S.

March 23: The Canadian government announces $275 million in funding for a number of Canadian research initiatives into vaccine development and testing. One of them is a Saskatoon lab that for four decades has been working on coronavirus vaccines primarily for animals, including successful vaccines for cattle and pigs.

March 21: There are two “vaccine candidates” in clinical evaluation, and 48 more in preclinical evaluation.

March 17: China gives the go-ahead for researchers at the country’s Academy of Military Medical Sciences to begin human safety tests of an experimental coronavirus vaccine.

March 16: Scientists at the Kaiser Permanente Washington Research Institute in Seattle begin a first-stage study of a potential COVID-19 vaccine when they administer the first shot to a volunteer patient. Code-named mRNA-1273, the vaccine candidate was developed by the U.S. National Institutes of Health and Massachusetts-based biotech company Moderna Inc.

LISTEN | The CBC News podcast Front Burner looks at the pursuit of a COVID-19 vaccine

With no clear end in sight, the urgent race for a vaccine is on across the world. This week, hopes for a vaccine grew as some biotech players are seemingly making progress. But, some experts caution that this process cannot be rushed – and that we are still far from seeing a vaccine on the market. 13:25

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