Solidarity: one of the most hopeful trials to combat COVID-19

It is no coincidence that the World Health Organization has baptized the world's largest clinical trial as "Solidarity", nor that more than eighty countries and hundreds of hospitals and research centers have already been involved in the search for the most effective treatment. effective against pathologies caused by coronavirus.

Dr. Vicente Estrada, principal investigator of this project at the San Carlos Clinical Hospital in Madrid – the center that coordinates this study nationwide – analyzes the expectations of this global initiative in an interview with EFE.

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"The most effective way to prevent infectious diseases is through a vaccine, also taking into account the global dimension of the disease; this is the fundamental hope, but unfortunately it will take a few months until it is available, so treatments are a part important management of this disease, "he said.

This is where Dr. Estrada stresses the importance of knowing which medications are the most appropriate for each patient and of identifying the best treatment for patients affected by Covid-19.

The global initiative "Solidarity", the most ambitious global research that has been launched in the world, will compare how four existing drugs and treatments or combinations of them work on infected patients.

The trials will focus on testing, initially, the use of the antiviral "remdesivir" used against Ebola; the combination of "lopinavir" and "ritonavir", which until now have been commonly used in HIV carriers; the "interferon beta" that is used against multiple sclerosis; and the "chloroquina" that is used regularly against malaria and rheumatism.

Could the "Solidarity" project be one of the most hopeful trials to combat the new coronavirus ?; "It is possible," replied Dr. Vicente Estrada, and pointed out that due to its design and the high number of participants, the study will soon offer results on the usefulness "or not" of the different branches that are already being analyzed.

It is also, the researcher explained, a trial with an "adaptive" design, so that depending on the results "some arms of the study could be eliminated and others could be incorporated with other drugs that have offered promising results."

While science advances in search of the vaccine against the new virus "we must know which medicines are the most appropriate for each patient," Dr. Vicente Estrada has observed, and has warned that Covid-19 is a disease of infectious, viral origin , but that in a proportion of patients it is accompanied by an "exaggerated" inflammatory response and that this response is precisely responsible for a very important part of the damage suffered by patients.

The Clinical Hospital, where he carries out his clinical and investigative work, has been the promoter of the "Solidarity" trial in Spain together with the Spanish Agency for Medicines and Health Products and has been the first center to recruit patients and the one that has included the most patients in the study in Spain.

Vicente Estrada has highlighted the rigor and safety of the tests; "it has the maximum guarantees of quality that a trial made in other conditions could have," he asserted, adding that there is "no risk to the safety of the patients participating in this clinical trial, and the drugs studied are those in which there is some scientific evidence of efficacy. "

He also appreciated that the Spanish research agencies have known how to react to the severity of the disease and have launched this trial "in record time".
And the inclusion of patients from numerous countries contributes to this study "more rigor than if it were a local study, since the results could be applicable to a greater number of patients," the researcher told EFE.

The promoter of the initiative, the World Health Organization, "is a prestigious international agency, not linked to any pharmaceutical company, that will analyze the results of the study in real time and the information will be public."

SARS-CoV-2 "is a very complex virus, capable of provoking an intense inflammatory response that is often responsible for its complications," said Vicente Estrada, who recalled that human beings had never been exposed to this virus. and therefore the immune system is unable to respond effectively during the early stages of infection.

The doctor has also highlighted its "enormous" transmission capacity, which explains the extensive spread of the disease, and has pointed out that, although its life cycle is known "in detail", there are still no treatments that have been proven effective in clinical practice.

Source: Raúl Casado for EFE