By Anna Kuchment
08:41 on August 14, 2020 CDT
So far, doctors and researchers have worked to save the lives of the sickest patients in COVID-19. This month, hospitals are implementing tests in North Texas to prevent others with milder COVID-19 symptoms from getting worse.
“When COVID arrived, we were desperately looking to save patients,” said Dr. Nancy Rollins, associate dean of clinical studies at UT Southwestern Medical Center. “As we learned how to care for acute patients, the question arose: can we know how many COVID patients end up going to the hospital?
This week, UT Southwestern opened an outpatient clinic committed to splitting a dozen remedies for patients with mild to moderate coVID-19 symptoms. Baylor Scott – White Health has also introduced outpatient trials.
This batch of experimental remedies includes the first medicines developed in particular to combat COVID-19. So far, doctors have been limited to remedies developed to combat other diseases such as Ebola, lupus and rheumatoid arthritis.
When patients are inflamed with the new coronavirus, their bodies need time to produce antibodies to counteract the infection.
Pharmaceutical corporations Regeneron and Eli Lilly have developed artificial antibodies that can be infused with patients shortly after they expand symptoms to help them expand a faster immune response. Eli Lilly’s drug is derived from antibodies extracted from one of the first U.S. patients. Starting with COVID-19. Regeneron’s infusion includes a cocktail of two antibodies to help prevent the virus from adapting to medications.
These so-called monoclonal antibodies are already used to fight cancer and autoimmune diseases and are well tolerated by patients, said Dr. Robert Gottlieb, who is the lead researcher in some of the COVID-19 clinical trials in Baylor Scott and White. Baylor tests the Eli Lilly and Regeneron formulations, while UT Southwestern tests the drug Regeneron.
Although any of the COVID-19 drugs have been shown promising in the lab, clinical trials are needed to demonstrate whether they can help patients with the virus more quickly. Trial volunteers will be randomly assigned to monoclonal antibodies or a placebo. They will get an intravenous infusion for singles in the Baylor emergency room or UT Southwestern outpatient clinic, and will be monitored for several weeks. (See clinical trial registration data at the end of this article).
Ambulatory remdesivir
Redesivir is the first drug to be effective against COVID-19. But until now, it was only held for hospitalized patients.
Starting this week, UT Southwestern will begin testing the re-11t at their outpatient clinic. The trial includes 3 intravenous infusions for 3 days, either remdesivir or placebo, and will be given to patients over 60 or 60 years of age or 18 to 60 years with one or more threat factors, such as chronic lung disease, hypertension. , obesity or cardiovascular disease. Patients are in poor health for seven days or less and are in poor health within 4 days of a positive nasal test.
Gilead Sciences, the company that developed the reuser, announced last month that it had also introduced clinical trials on inhaled redesivir, but no local trials have yet been announced. Patients would get a formula from the drug that can simply be added to a nebulizer and inhaled through a mask.
Last week, Baylor Scott-White also became the first to enroll hospitalized patients in an overseas examination sponsored by the National Institutes of Health to verify monoclonal antibodies mixed with remdesivir. While antibodies prevent the virus from infecting cells, remdesivir prevents the virus from replicating internally into cells.
“We know that it is more productive to attack a virus at other stages of its life,” Gottlieb said. “These are very complementary approaches.”
Antiviral pills
Another drug for redesivir that can be taken as a tablet is also being checked locally. In September, UT Southwestern will check the antiviral drug favipiravir, which was first approved to treat influenza in Japan.
Russia, China and India have approved it to treat COVID-19. Stanford University will examine whether the drug can help relieve symptoms and speed healing.
Calming the immune system
While the new coronavirus itself reasons for the body, many patients have also suffered a hyperimmune reaction known as cytokine storm.
When the immune formula overreacts, it attacks the body’s own tissues and can damage the organs by adding the lungs. To calm the immune formula, UT Southwestern will check a common gout tablet called colchicine to see if it can relieve COVID-19 headaches by adding the respiratory formula.
Interested participants must be at least 40 years old and threatened as diabetes, high blood pressure or obesity; you have symptoms of COVID for a week or less and have had a positive nasal pattern in the last 48 hours.
Test problems
All outpatient clinical trials require patients to test positive for COVID-19, and many are for volunteers who have shown symptoms for less than seven days. This can be a challenge with existing check delays, so doctors propose calling to locate sites with quick control deadlines.
While outpatient trials mark a promising new step in the fight against COVID-19, none of the drugs are likely to end the crisis in the short term, UT Southwestern’s Rollins said.
“It’s a complex disease that we’re just beginning to perceive,” he said. “Many studies will be needed to perceive healing agents, and they will not be the same for all facets of COVID or for all populations of COVID patients. The smartest thing other people can do is distance themselves socially, wear a mask, wash their hands and be smart.
FOR MORE INFORMATION
Those interested in learn more about outpatient clinical trials can call UT Southwestern and Baylor Scott – White Health.