Penn Covid-19 Research: Kaletra Most-Used Drug for COVID-19 Treatment

Penn's David Fajgenbaum, M.D., MBA, is branching out from Castleman disease to assemble comprehensive registry of drugs to treat COVID-19.

In late May, we wrote about David Fajgenbaum, M.D., MBA, and his efforts to create a complete database of all of the different off-label drugs that have been used to treat COVID-19.

Fajgenbaum, an assistant professor of medicine at the University of Pennsylvania who has become well known as a patient, researcher and advcoate for Castleman disease, was a guest speaker at ASCO's annual meeting, held over the internet because of COVID-19.

Now we have come company.

CNN posted a story yesterday about Fajgenbaum and his efforts to create a comprehensive registry of the drugs being used to treat COVID, both-19 the new ones and the ones that are being repurposed to treat COVID-19 after being used to treat other diseases.

As CNN reported, Fajgenbaum and his colleagues have reported their first results, a review of 2,706 articles about COVID-19 patients and treatment, in the journal Infectious Diseases and Therapy. Those articles were winnowed down to 155 studies that met the group's inclusion criteria.

The most frequently administered drug classes were antivirals, antibiotics, and corticosteroids — no surprise there. Two weeks ago, British researchers announced the results of a randomized trial that showed that a corticosteroid, dexamethasone, reduced deaths by a third among ventilated COVID-19 patients.

Fajgenbaum and his colleagues said their research showed that the lopinavir-ritonavir combination (sold as Kaletra) was the most commonly used drug. Hopes for Kaletra as a COVID-19 treatment sagged after negatives results were reported in March in the New England Journal of Medicine, although some questioned whether the combination was ineffective shown to be ineffectivec in that trial only because it was given too long after people were infected with the SARS-CoV-2 virus that causes COVID-19. In general, antivirals are more effective if they are given soon after someone is infected.

The lopinavir-ritonavir combination is one of treatments under investgation in the international Solidarity Trial launched by the World Health Organization (WHO). Researchers are investigating lipinavir-ritonavir by itself and when it is used interferon beta-1a, a multiple sclerosis treatment. Solidarity Trial researchers are also investigating Gilead's remdesivir.

Mid-June, WHO announced that it was halting the Solidarity study of hydroxychloroquine, the drug that President Trump touted, after results showed that it didn't lower the mortality rate of hospitalized COVID-19 patients.