Discover and read the best of Twitter Threads about #lopinavir

Most recents (7)

🔥Voilà un thread afin de ne pas avoir à répéter tout le temps la même chose sur la recherche médicale thérapeutique pendant #COVID19 #SARS_CoV_2 #pandemic

👇👇
1/ Les infectiologues cliniciens n'attendaient pas de ttt antiviral permettant une amélioration "spectaculaire" pr une maladie aiguë virale sévère (cf dengue, zika, chik, grippe), il était donc nécessaire d’évaluer rigoureusement et d’espérer un ttt un peu efficace et non toxique
2/ Il existe de nombreux candidats repositionnés qui ont été utilisés et testés et ce dès le début de la pandémie : #lopinavir/#ritonavir, #remdesivir, #hydroxychloroquine, #interferon ß pour n’en citer que quelques-uns
Read 35 tweets
1/
Should we use #Lopinavir-ritonavir (LPV/r) + #Ribavirin (RBV) +/- #Interferon beta-1b (IFN) to treat #SARSCoV2 #COVID19? Let’s take a look at the data.

Here’s: #HowIReadThisPaper on @TheLancet trial of triple therapy for COVID19

Hung et al: thelancet.com/journals/lance…
2/
First, let’s assess our baseline beliefs about triple therapy:

Before reading this study, when considering triple therapy as a treatment for patients with COVID19, I think the most important component is likely to be:
3/
Background: A 2003 case series suggested ↓mortality (vs historical controls) in SARS patients treated with LPV/r + RBV :

ncbi.nlm.nih.gov/pmc/articles/P…

In 2015, LPV/r and IFN led to ↓viral load and improved clinical outcomes in animal models of MERS:

pubmed.ncbi.nlm.nih.gov/26198719/
Read 30 tweets
1/ Little Thread about all The Misleading Medical Information still floating around about #Hydroxychloroquine & #Chloroquine & #Azithromycin & #ZelenkoProtocol - by 1 doctor - @zev_dr & #Remdesivir & more

Despite #TrumpIsNotADoctor has stopped saying "What do you have to lose?".
2/ #TrumpIsTheWORSTPresidentEVER

First, why it has been political all the way, suspected from day one:

"Trump had been touting HCQ for weeks, sparking worldwide shortages of HCQ & prompting negotiations with Indian PM Modi to lift export restrictions"

vanityfair.com/news/2020/04/i…
3/ #Trump2020

Indian PM Modi and Trump held a rally together.

"Mr Trump wanted to show people in the US that he was hugely popular abroad and that he was capable of negotiating good deals out of a country he once described as the king of tariffs"

bbc.com/news/world-sou…
Read 42 tweets
What evidence has the @JHSPH_NCRC reviewed to date on treatments for COVID-19? 💊💉🩸
From Gautret et al. in International Journal of Antimicrobial Agents:
Viral shedding appeared lower in the #hydroxychloroquine arm; however, important differences between groups may also explain the effect seen. bit.ly/2W5meov
From Gautret et al. in International Journal of Antimicrobial Agents:
The study did not formally assess clinical endpoints, and it is unclear whether there is #COVID19 clinical benefit with #hydroxychloroquine treatment. bit.ly/2W5meov
Read 8 tweets
1/
Should we use #lopinavir-ritonavir (LPV/r) to treat #COVID19 #SARSCoV2? Let’s take a look at the data.

Here’s: #HowIReadThisPaper on the @NEJM trial of LPV/r for COVID19 in humans: LOTUS China

Cao et al: nejm.org/doi/full/10.10…

(Thread)
2/
Background: Lopinavir, an HIV protease inhibitor, is active in vitro against SARS-CoV and in animal models of MERS-CoV. Ritonavir inhibits CYP3A and increases serum half-life of lopinavir. A 2004 uncontrolled study of LPV/r + ribavirin suggested a benefit in SARS in humans.
3/
Question: Is LPV/r safe and efficacious for shortening time to clinical improvement in patients hospitalized with #COVID19?

Date Published: 18 March 2020

Funding: Major Projects of National Science and Technology on New Drug Creation and Development
Read 29 tweets
Starting a series on clinical Pearls I am gathering in #COVID19 patients based on experiences of many experts

Will add as we go along

Feel free to add your own observations/experiences

#covidclinicalpearls /1
Anosmia is likely the most specific #COVID19 related symptom
30% of patients have anosmia as their 1st symptom
#covidclinicalpearls /2
Around 90% of patients have fever.
50% maybe afebrile at the time of presentation
Fever tends to be very resistant to routine measures in hospitalized patients
There is no consensus that NSAIDs are to be avoided in #COVID2019 patients

#covidclinicalpearls /3
Read 66 tweets
There is no proven effective antiviral drug for the treatment of #SARSCoV2

Several compounds are suggested for Rx of #COVID19. Based on the available in vitro and clinical data, which one is your preferred Rx, if available? #MayoIDQ references follow...
1/
#Chloroquine
Anti-malaria

Several potential mechanisms: change in cell membrane pH, impairs viral fusion, interferes with glycosylation of viral proteins

#chloroquine and #redemsivir are active against SARS-COV2 in experimental models

doi.org/10.1038/s41422…
2/
#Hydroxychloroquine
- Analogue of chloroquine
- Anti inflammatory effect

Hydroxychloroquine was more potent than chloroquine against #SARS-CoV2 in vitro.

doi.org/10.1093/cid/ci…
Read 17 tweets

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