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Infectious Diseases

Updated 30 April 2020

Lopinavir-ritonavir not effective against Covid-19, says Department of Health

As many scientists are trying to find effective specific treatments for Covid-19, we are now discovering what works – and what doesn’t.

While there is no vaccine to protect against the new coronavirus, scientists and medical experts are buying time by looking at the effects of existing drugs.

Lopinavir-ritonavir (LPV/r) is a combination of antivirals used to treat HIV.

Why this HIV drug?

The possibility of using this drug combination to treat Covid-19 started when the World Health Organization (WHO) announced their Solidarity trial – a collaboration between different countries, where four existing drugs would be trialled to determine their effect on Covid-19 patients.

One of these drugs is the lopinavir-ritonavir combination. While there was no certainty that it would be effective in Covid-19 patients, there were some positive indications from laboratory experiments, according to the WHO.

Now, the South African Department of Health conducted a rapid review of available published clinical evidence and found it doubtful whether the lopinavir-ritonavir combination could be a viable treatment option.

What the Department found

According to a press statement, the Department of Health did a search on 11 April 2020 on two electronic databases (Epistemonikos and PubMed) to review existing evidence of the clinical effects of lopinavir-ritonavir.

They also searched for any pre-printed studies on medrxiv.org to find evidence.

In their search, they looked at 64 records of research, including two trials that were conducted in China. One trial included severe Covid-19 cases, while the other trial focused on mild to moderate cases. 

They came to the conclusion that there is not sufficient evidence to indicate that lopinavir-ritonavir is an effective treatment for Covid-19. While it posed no serious side effects in patients, it was linked to an increase in non-serious gastrointestinal side-effects.

Based on their review of current, existing data, lopinavir-ritonavir is not recommended as a treatment for Covid-19.

Another study deemed drug not effective

Research, published in the journal Med, also showed in a randomised, controlled study that the drug didn’t improve the outcome of mild to moderate Covid-19 patients.

"We found that neither lopinavir-ritonavir nor Arbidol could benefit clinical outcomes for patients and that they might bring some side effects," says co-senior author Linghua Li, Vice Director of the Centre for Infectious Diseases of Guangzhou Eighth People's Hospital in Guangzhou, China, in a news release

Warning against using unproven medication

While there is currently no targeted treatment for Covid-19, doctors are treating cases based on their specific symptoms.

But the national drug regulator warned that some doctors are prescribing unproven treatments, including chloroquine, a malaria drug that received a massive amount of press for its supposed benefits against Covid-19.

Unregulated and arbitrary prescription of this medication is not only not yet backed by science, it’s also a missed opportunity to gain information on possible coronavirus treatments in a way that could be useful for future outbreaks, according to a previous article in Health24.

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