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World bets on existing drugs to combat coronavirus

Thai doctors say novel mixture worked in one case, but experts remain guarded

Using an existing drug as the basis for a cure would eliminate much of the lengthy safety testing and clinical trials required for new drugs. (Source photos from EPA, National Institute of Infectious Diseases)

TOKYO -- Doctors and researchers are trying existing drugs to treat pneumonia caused by the new coronavirus, but experts warn that more tests are needed and people should not pin their hopes on unverified reports.

Thailand's Ministry of Public Health announced on Sunday that a coronavirus patient had improved after being administered a mixture of the flu drug oseltamivir and HIV drugs lopinavir and ritonavir.

Before taking the drugs, the 71-year-old Chinese tourist had shown no signs of recovery for 10 days after being identified as a virus carrier. Within 48 hours of receiving the drugs, however, she improved and tested negative for the virus.

The Chinese Academy of Sciences is experimenting with about 30 drugs, including the ones used on the recovering patient and anti-HIV Kaletra from U.S. drugmaker AbbVie.

China has already conducted a human trial using Kaletra, leading AbbVie to announce that it will donate about $2 million of Kaletra to the Chinese government.

Companies are scrambling to find new ways to battle the virus. GlaxoSmithKline announced on Monday that it will partner with the Coalition for Epidemic Preparedness Innovations to develop a vaccine. The U.K.-based company currently has 14 HIV drugs on the market.

A number of reports on candidate drugs have been posted to online medical journals. As of Tuesday morning, eight reports have been released, including one about drugs made by a Japanese pharmaceutical company.

Researchers at the Chinese Academy of Sciences and others reported on Japan Tobacco's nelfinavir on Jan. 28, while researchers at China's military medical university and Sichuan University reported on HIV drugs made by U.S. maker Gilead Sciences on Jan. 30.

Both tests, however were computer simulations, leaving in doubt the drugs' efficacy on actual patients.

Candidate drugs are chosen based on how viruses grow. Coronavirus, HIV and influenza are RNA viruses, which replicate in similar ways. Many existing drugs inhibit viral growth and thus are expected to have similar effects on the new coronavirus.

Using an existing drug would speed development of a cure, as new drug development often takes decades due to the need for lengthy safety testing on animals and clinical trials on humans.

Due to the urgency of the situation, China is believed to be relaxing regulations to shorten the development time for a coronavirus treatment. Ordinarily, administering existing drugs for the treatment of diseases other than that for which they are approved requires separate testing.

In Japan, public medical insurance normally does not cover drugs under development unless they first undergo clinical trials for safety and efficacy. Although the government has not yet made exceptions for the current outbreak, it may allow infected patients to take candidate drugs in a clinical trial setting or subsidize their use.

Most experts agree, however, that none of the drugs have been confirmed effective.

"Many patients exhibit only light symptoms from the coronavirus, or recover completely without needing treatment," said Hitoshi Oshitani, professor at Tohoku University School of Medicine. "So you can't be sure if a drug has had an effect on a patient who recovered after taking it."

Oshitani noted efforts at finding drugs to battle the SARS outbreak in 2002-2003.

"There were many news reports that drugs for other diseases were found effective, but none of them panned out in the end," Oshitani said.

Although there may be more reports of someone having found an effective drug going forward, "you should take them with a grain of salt" until clinically proven.

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