HCV drugs sofosbuvir, daclatasvir show promise as potential COVID-19 treatment
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Using hepatitis C drugs sofosbuvir and daclatasvir in combination with standard care to treat patients with COVID-19 resulted in better 14-day recovery rates and a shorter hospital stay, according to data presented at AIDS 2020.
“Laboratory studies have shown that daclatasvir has antiviral activity against SAR-CoV-2 and penetrates well into the lungs where COVID-19 infection can be concentrated, while sofosbuvir has only marginal antiviral activity,” Andrew Hill, MD, PhD, senior visiting research fellow in the pharmacology department at Liverpool University, said during a session on Thursday. “If this treatment proves to be effective, it could be made available worldwide as a cheap, generic treatment costing approximately $7 per 14-day treatment course.”
According to Hill, “there is already enough generic mass produced to treat millions of people” if the treatment proves to be effective in larger trials.
To assess the effectiveness of the drug combination for moderate or severe COVID-19, Hill and colleagues gathered data on patients with COVID-19 at four Iranian University hospitals who were given the treatment during the first wave of the epidemic. Patients were randomly assigned to standard care (hydroxychloroquine ± lopinavir/ritonavir) with or without sofosbuvir and daclatasvir.
Of 66 patients assessed in the study, 33 received sofosbuvir and daclatasvir; the rest received the standard of care. Baseline characteristics were similar between the treatment groups.
Results showed that after 14 days, 29 patients (88%) in the sofosbuvir and daclatasvir group reached clinical recovery compared with 22 (67%) in the control group (P = .076). Patients in the sofosbuvir and daclatasvir group experienced a shorter duration of hospital stay and median time to discharge compared with the control group (6 vs. 8 days and 6 vs. 11 days, respectively).
Three patients in the sofosbuvir and daclatasvir group died compared with five in the control group. No serious adverse events were reported.
“[Despite] these encouraging results, we believe it’s too early to reach a verdict on this treatment,” Hill said. “We need larger, well-designed studies to confirm our results.”
According to Hill, researchers have already set up a network of randomized trials to test the combination of sofosbuvir and daclatasvir in more than 2,000 patients with COVID-19 in Brazil. Egypt, South Africa and Iran. There are also more than 2,000 set to be enrolled in prevention trials testing the same drug combination.
National Institute of Allergy and Infectious Diseases Director Anthony S. Fauci, MD, who spoke during the session, said the results from Hill and colleagues are “really interesting and provocative.”
“The preliminary information is really interesting, because we desperately need an antiviral that can be given early on in the course of the disease to prevent individuals from going on to require hospitalization,” Fauci said. “I would encourage, as Dr. Hill did himself very clearly, further studies on this to nail this down in a randomized control trial.”
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Sadeghi A, et al. Sofosbuvir and daclatasvir as a potential candidate for moderate or severe COVID-19 treatment, results from a randomised controlled trial. Presented at: International AIDS Conference; July 6-10, 2020 (virtual meeting).
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