The most promising therapeutics for COVID-19

updated: 6 July 2020     original published date: 17 May 2020

This rapid research brief synthesises the evidence on the most promising COVID-19 therapeutics in development globally and nationally, their mechanisms of action, their stage of development and their strengths and limitations.

The original brief was delivered on 17 May 2020 and the most recent update was provided on 6 July 2020.

Key findings:

  • There are over 300 potential COVID-19 therapeutics being explored in pre-clinical testing and of these, 200 are in clinical trials.

  • Preliminary Phase III clinical trial data are now available for remdesivir and indicate that it mayquicken recovery for COVID-19 patients. However, there is no statistically significant evidence of a reduction in mortality rates. The National COVID-19 Clinical Evidence Taskforce in Australia has given remdesivir a conditional recommendation, meaning its use as a therapeutic outside the context of clinical trials may be considered.

  • Emerging results on the use of hydroxychloroquine as a therapeutic suggest it may not be effective, but these data are still being peer reviewed. Use for post-exposure prophylaxis is still under investigation but early results have not shown a benefit. Use for pre-exposure prophylaxis is still under investigation.

  • Dexamethasone, a corticosteroid, is the first drug shown to improve the survival of hospitalised COVID-19 patients requiring respiratory support, including supplemental oxygen and invasive ventilation.

  • Emerging evidence suggests that anticoagulation therapy could be used to prevent thrombotic complications in patients with severe COVID-19.

  • The first randomised clinical trial of convalescent plasma therapy suggests it may not improve time to recovery for hospitalised patients, but the available data are currently limited.

Contributing authors
Lead author: Professor Sharon Lewin AO FAHMS
Lead author: Professor Sharon Lewin AO FAHMS Director, Doherty Institute; Professor of Infectious Diseases, University of Melbourne; Consultant Infectious Diseases Physician, Alfred and Royal Melbourne Hospitals
Professor David Copolov AO
Professor David Copolov AO Prof Vice-Chancellor (Major Campuses and Student Engagement), Monash University
Professor Brendan Crabb AC FAHMS
Professor Brendan Crabb AC FAHMS Director and CEO Burnet Institute
Professor Andrew Cuthbertson AO FAA FTSE FAHMS
Professor Andrew Cuthbertson AO FAA FTSE FAHMS Chief Scientist, CSL Limited
Professor Peter Doherty AC FAA FRS FAHMS Nobel Laureate
Professor Peter Doherty AC FAA FRS FAHMS Nobel Laureate University of Melbourne
Professor Wendy Hoy AO FAA
Professor Wendy Hoy AO FAA Director Centre for Chronic Disease, University of Queensland
Professor Anthony Kelleher FAHMS
Professor Anthony Kelleher FAHMS Program Head – Immunovirology and Pathogenesis Program, Kirby Institute
Dr Suman Majumdar
Dr Suman Majumdar Deputy Program Director, Health Security, Burnet Institute
Professor Gilda Tachedjian
Professor Gilda Tachedjian Head, Life Sciences Discipline, Burnet Institute and President, Australasian Virology Society
Peer reviewers
Professor James McCarthy FAHMS
Professor James McCarthy FAHMS Director, Victorian Infectious Diseases Service, Royal Melbourne Hospital and Professor of Infectious Diseases, University of Melbourne at the Doherty Institute
Professor Paul Myles FAHMS
Professor Paul Myles FAHMS Director, Department of Anaesthesiology and Perioperative Medicine, Alfred Hospital and Monash University
Professor Marc Pellegrini FAHMS
Professor Marc Pellegrini FAHMS Joint Division Head, Infectious Diseases and Immune Defence, Walter and Eliza Hall Institute of Medical Research
Professor Steve Webb FAHMS
Professor Steve Webb FAHMS Senior Staff Specialist in Intensive Care, University of Western Australia; Professor of Critical Care Research, Monash University
Image of Professor John Shine AC PresAA
Professor John Shine AC PresAA President of the Australian Academy of Science

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