Hospitals across Canada are leading a research effort examining potential treatments for COVID-19 as part of the Solidarity Trial, a multinational initiative being coordinated by the World Health Organization (WHO) and supported by the Canadian Institutes of Health Research (CIHR).
Reflecting an unprecedented level of global collaboration, the goal of the Solidarity Trial is to compare the safety and effectiveness of different drugs and drug combinations in treating patients who are hospitalized with COVID-19.
“Trials like this are important because when faced with a new disease like COVID-19, it’s important that clinicians and patients do not turn to unproven therapies,” says Dr. Srinivas Murthy, a clinical associate professor in the University of British Columbia’s department of pediatrics and an infectious diseases and critical care physician at BC Children’s Hospital.
Patients requiring hospitalization for COVID-19 at one of 20 participating hospitals will be eligible for the trial, known as CATCO (Canadian Treatments for COVID-19). The trial will start by evaluating lopinavir-ritonavir, a combination of antiviral agents also used in treatment of HIV, compared with optimized supportive care. Other medications – an antiviral remdesivir and hydroxychloroquine/chloroquine – will be added shortly thereafter.
“These types of trials ensure that patients are assigned to the most promising available treatments, so that evidence regarding the safest, most effective therapies is generated in the shortest possible time,” says Murthy, who is principal investigator of the CATCO trial.
“The combination of medications we’ll be using have shown promise in pre-clinical work. Sunnybrook was the first hospital in Canada to start enrolling patients this week, and we expect our colleagues in B.C. will be able to enrol patients starting in the next week or so,” says Dr. Rob Fowler, critical care physician and chief, Tory Trauma Program at Sunnybrook Health Sciences Centre in Toronto, which is sponsoring the CATCO trial and helping to coordinate it at all Canadian hospitals.
Results from the trial will provide clinicians with evidence-based research on which drugs can be used to treat the virus in a way that is safe for patients. Current treatment options for COVID-19 are limited to providing supportive care, such as ventilators.
“Since these drugs have been successfully used to treat other diseases such as HIV and malaria, we have a better understanding of the drug profiles, as well as possible side effects to look for in our patients,” says Fowler, who is also a senior scientist at Sunnybrook Research Institute.
Data collected from participating hospitals will be submitted to a central repository managed by the WHO. Ultimately, the Solidarity Trial will enroll thousands of patients from dozens of countries.
The CATCO trial is being conducted with support from CIHR, and through the Canadian Critical Care Trials Group and the Association of Medical Microbiology and Infectious Disease Canada.