Officials from the World Health Organization (WHO) announced last week that the large global treatment trial that it is leading will drop the hydroxychloroquine arm and that it is taking steps to update its clinical guidance based on new promising treatment findings of the steroid dexamethasone in severely ill patients.
The global Covid-19 total grew to 8,278,155 cases last week, and 446,202 people have died from their illnesses, according to the Johns Hopkins online dashboard.
At a World Health Organization (WHO) media briefing last week, Ana Maria Henao Restrepo, MD, unit head of the WHO’s research and development blueprint, said the review board of the SOLIDARITY trial—a large international randomized controlled trial to test four treatments—looked at the evidence from recent hydroxychloroquine trials.
The evidence included data from the Recovery trial in the United Kingdom, in which researchers recently pulled the plug after a review found no benefit for the antimalarial drug.
She said the review board also talked to the principal investigators of the studies before advising that the hydroxychloroquine arm should be stopped. In an email statement, the WHO clarified that investigators won’t randomize any more patients to the hydroxychloroquine arm and that patients who have already started the drug may complete their course or stop, based on the advice of supervising doctors.
Restrepo emphasized that the recommendation doesn’t constitute WHO policy about the drug or apply to any other studies involving it for pre- or post-exposure.
WHO welcomes dexamethasone results
In another development, WHO Director-General Tedros Adhanom Ghebreyesus, PhD, said that unpublished data from a UK trial that showed a benefit of dexamethasone for severely ill patients, though not for those with milder disease, is welcome news, but he said the drug should be used only under close supervision.
“We need more therapeutics that can be used to tackle the virus, including those with milder symptoms,” he said.
Based on the findings, he said the WHO is coordinating a meta-analysis to pool data from several clinical trials involving the steroid to increase its overall understanding of the intervention and will update its guidance on how and when dexamethasone should be used to treat COVID-19.
In other comments during the briefing, he noted that the WHO and its partners have developed a new roadmap for neglected tropical diseases that moves single disease programs into a more integrated prevention, diagnosis, and treatment approach, with an eye toward universal health coverage.
Tedros said the plan also puts greater ownership on national and local governments and, as with Covid-19, calls for greater collaboration among governments.