Antiviral drugs trialled in the early stages of Covid-19

UCLH has begun recruiting patients and healthcare staff to a trial looking at whether two antiviral drugs given to people who have tested positive for Covid-19 can stop the virus replicating.

The FLARE trial aims to see if favipiravir and lopinavir/ritonavir, alone or in combination, can inhibit viral replication in early infection - within the first few days of illness.

Recruitment is taking place across London of people who have tested positive for Covid-19 and are self-isolating at home after a positive test result, either asymptomatic or in the first few days of symptoms.

The study includes an arm specifically involving healthcare staff. Overall up to 240 adults aged 18 to 70 will be recruited to the randomised placebo controlled trial and participants will take oral medication (tablets) for seven days.

Finding antivirals that decrease viral load early on may reduce the risk of transmission and later hospitalisation.

The UCLH portion of the trial is being led by Infectious Diseases consultant Dr Nicky Longley, who said: "This is a trial to see if giving antiviral medication early in infection will reduce the amount of the virus in the respiratory tract. We hope that this will reduce risk of getting severely unwell from COVID and hopefully reduce the risk of passing it on to others."

Favipiravir blocks the enzyme that allows the virus to replicate. The drug is approved for treatment of influenza in Japan. The drug has already been used to successfully treat serious viral infections in immunocompromised patients at Great Ormond Street Hospital and the Royal Free Hospital.

Lopinavir/ritonavir works by blocking an enzyme that processes proteins that the virus needs for growth.

The trial is funded by LifeArc and is led by UCL and run in partnership with the Royal Free Hospital, University College London Hospitals (UCLH) and Great Ormond Street Hospital NHS trusts.

If this study is successful, researchers later plan to investigate this strategy of early antiviral treatment in high-risk patients to prevent serious outcomes from the disease including hospitalisation and death.

People wishing to volunteer to take part in the trial can contact: uclh.covidresearch@nhs.net.

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