Study: New Triple Antiviral Drug Combination Shows Early Promise for COVID-19 Treatment

A 2-week antiviral therapy with interferon beta-1b plus lopinavir-ritonavir and ribavirin is safe and more effective at reducing the duration of viral shedding than lopinavir-ritonavir alone in patients with mild to moderate coronavirus disease 2019 (COVID-19), according to a clinical trial published by The Lancet.¹

The first randomized trial involved 127 adults from 6 public hospitals in Hong Kong. The patients were randomly assigned 2:1 to a 14-day combination of lopinavir 400 mg and ritonavir 100 mg every 12 hours, ribavirin 400 mg every 12 hours, and 3 doses of 8 million international units of interferon beta-1b on alternate days (combination group) or to 14 days of lopinavir 400 mg and ritonavir 100 mg every 12 hours (control group).²

The median number of days from symptom onset to the start of study treatment was 5 days. The combination group had a significantly shorter median time from start of study treatment to negative nasopharyngeal swab than the control group, according to the researchers. Adverse events included self-limited nausea and diarrhea with no difference between the 2 groups.²

"Our trial demonstrates that early treatment of mild to moderate COVID-19 with a triple combination of antiviral drugs may rapidly suppress the amount of virus in a patient's body, relieve symptoms, and reduce the risk to health care workers by reducing the duration and quantity of viral shedding (when the virus is detectable and potentially transmissible),” said researcher Kwok-Yung Yuen in a press release. “Furthermore, the treatment combination appeared safe and well tolerated by patients.”¹

The study authors found that early triple antiviral therapy was safe and superior to lopinavir-ritonavir alone in alleviating symptoms and shortening the duration of viral shedding and hospital stay in patients with mild to moderate COVID-19. Further clinical study of a double antiviral therapy with interferon beta-1b as a backbone is suggested, according to the study authors.²

REFERENCES

• The Lancet: New triple antiviral drug combination shows early promise for treating COVID-19 in phase 2 randomized trial. EurekAlert! https://www.eurekalert.org/pub_releases/2020-05/tl-pss050820.php. Published May 8, 2020. Accessed May 15, 2020.
• Hung IF, Lung KC, Tso EY, et al. Triple combination of interferon beta-1b, lopinavir—ritonavir, and ribavirin in the treatment of patients admitted to hospital with COVID-19: an open-label, randomised, phase 2 trial. The Lancet. doi: https://doi.org/10.1016/S0140-6736(20)31042-4.