Results of the @WHO SOLIDARITY trial:

4 drugs tested in 11,266 patients with COVID in 405 hospitals in 30 countries:
- hydroxychloroquine
- lopinavir
- remdesevir
- interferon

No clear benefit of any of them on survival.…
Similar results in different age-groups and whether on mechanical ventilation or not:
We knew about hydroxychloroquine - these results are entirely consistent with RECOVERY:…
We knew about lopinavir- these results are entirely consistent with RECOVERY:…
There has been interest in Interferon. Doubtless there will be discussion about route of administration etc

But this is the best evidence there is - and it is not encouraging.
But the big discussion will be about remdesevir.

How do the SOLIDARITY results fit will the other available information:

Overall - no effect on survival
On ventilation - no effect on survival
Not on ventilation - no clear effect on survival; consistent effect with the overall
People will argue about the need for earlier use (possibly) or that with even more data there may be a benefit (possibly - but where are those trials going to come from).

But the effect is modest at best - and so far there is no strong evidence it is there at all.
Remember, remdesevir is given by intravenous infusion for 5-10 days. It is not cheap. And supplies are limited (not surprising given scale of epidemic).
COVID affects millions of people & their families around the world. It is not a rare disease and we need scalable, affordable, and equitable treatment solutions.

The @WHO SOLIDARITY trial has done the world a huge favour by producing clear, independent evidence.

Many thanks.

• • •

Missing some Tweet in this thread? You can try to force a refresh

Keep Current with Martin Landray

Martin Landray Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!


Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @MartinLandray

15 Oct
The @WHO SOLIDARITY trial is a major international achievement.

Knowing which treatments do not have meaningful impact on mortality is important - saves resources, refocuses scientific attention, benefits patients.
Doubtless there will be much discussion, not all of which will be as objective as we need in a pandemic.

But this trial is randomised, large, and focused on the ultimate clinical outcome - mortality.
Huge congratulations to all involved - from top to bottom, from around the world.
Read 4 tweets
8 Oct
More results from the RECOVERY trial - Hydroxychloroquine:

Among patients hospitalised with COVID-19, hydroxychloroquine (HCQ) did not improve 28-day mortality, duration of hospital stay, or risk of progressing to invasive mechanical ventilation or death… Image
1561 patients were randomised to HCQ + usual care
3155 patients were randomised to usual care alone
in the largest randomised trial of HCQ for treatment of COVID Image
No evidence of benefit of HCQ on any of the pre-specified endpoints. Image
Read 14 tweets
7 Oct
Great summary of treatments for hospitalised patients with COVID-19 @rupert_pearse…
My take on this:

Dexamethasone improves survival.
Remdesivir shortens time to recovery.
Hydroxychloroquine & lopinavir are ineffective.

** we know because the clinical trials have been done**
Tocilizumab, Convalescent plasma, and neutralising antibodies look promising

** we will know because we are doing the clinical trials**
Read 5 tweets
6 Oct
Latest paper from RECOVERY trial:

In patients admitted to hospital with COVID-19, lopinavir–ritonavir did not reduce 28-day mortality, duration of hospital stay, or risk of progressing to invasive mechanical ventilation or death.…
Lopinavir-ritonavir is an HIV treatment that was widely recommended and used for #COVID19. The RECOVERY trial has shown it does not work - so doctors no longer use it.

That’s why we do trials - to separate out drugs we think might work from drugs we know do work.
As always, huge thanks to all involved including funders (@UKRI_News @NIHRresearch), colleagues (@OxfordBRC @hdruk @Oxford_NDPH @NDMOxford), the NHS (@NHSEngland @NHSDigital) and the thousands of medical staff across the whole UK.

But most especially to our amazing patients.
Read 9 tweets

Did Thread Reader help you today?

Support us! We are indie developers!

This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Too expensive? Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal Become our Patreon

Thank you for your support!

Follow Us on Twitter!