By March 2020, the international Coalition for Epidemic Preparedness Innovations (CEPI) committed to research investments of US$100 million across several countries, and issued an urgent call to raise and rapidly invest $2 billion for vaccine development. In early 2020, numerous established antiviral compounds for treating other infections were being repurposed or developed in new clinical research efforts to alleviate the illness of COVID-19.
During March, funding for the Solidarity trial reached US$108 million from 203,000 individuals, organizations and governments, with 45 countries involved in financing or trial management.
Drugs Development Against Covid 19: Phase III trials
Favipiravir: In people with COVID-19, favipiravir (marketed as Avigan and approved for use in Japan in 2014 for several viral diseases) was found to be safe and had preliminary efficacy in an early-stage trial in Shenzhen, China.
Remdesivir: the Gilead Sciences antivirus drug candidate is in multiple clinical trials, with preliminary results expected in May 2020, and was launched in two Phase III efficacy trials in Hong Kong, Singapore, South Korea and the United States in March 2020. On 21 March, the United States Centers for Disease Control and Prevention (CDC) issued a physician advisory concerning remdesivir for people with pneumonia caused by COVID-19:
“While clinical trials are critical to establish the safety and efficacy of this drug, clinicians without access to a clinical trial may request remdesivir for compassionate use through the manufacturer for patients with clinical pneumonia.”
ASC-09 + ritonavir (oral tablet): ASC-09 (product of the Chinese firm, Ascletis Pharma Inc.), a HIV-1 protease inhibitor in combination with ritonavir, was initiated in a Phase III trial in China during February 2020 to assess efficacy against COVID-19.
Tocilizumab: a monoclonal antibody with activity against the interleukin-6 receptor involved in inflammation, tocilizumab is already marketed under the trade name, Actemra, to treat arthritis. It is under clinical development to determine safety and efficacy against pneumonia in hospitalized people with COVID-19.The manufacturer, Genentech, announced the April start of a Phase III trial across several countries.
Chloroquine or Hydroxychloroquine: In late January 2020 during the 2019–20 coronavirus pandemic, Chinese medical researchers stated that exploratory research into chloroquine and two other medications, remdesivir and lopinavir/ritonavir, seemed to have “fairly good inhibitory effects” on the 2019 novel coronavirus. Chloroquine had been also proposed as a treatment for SARS-CoV with in vitro tests inhibiting the virus.
On 28 March 2020, the US FDA enabled use of oral tablets of chloroquine phosphate or hydroxychloroquine sulfate under an emergency use authorization at the discretion of physicians treating people with COVID-19. The FDA official stated “that it is reasonable to believe that the known and potential benefits of chloroquine phosphate and hydroxychloroquine sulfate, when used for the treatment of SARS-CoV-2 and used consistently with the Scope of Authorization of this letter (Section II), outweigh the known and potential risks of these products.