Does lopinavir measure up in the treatment of COVID-19?

Abstract

INTRODUCTION:

Lopinavir in combination with ritonavir is approved for the treatment of HIV and has recently been subject to a clinical trial in severe COVID-19.

AREAS COVERED:

This evaluation is of LOTUS China (the Lopinavir Trial for Suppression of SARS-Cov-2 in China), which was a randomized trial in hospitalized subjects with COVID-9 in a respiratory sample and pneumonia. As, in severe COVID-19, lopinavir/ritonavir had no beneficial effects but increased gastrointestinal adverse effects, this combination should not be used at this stage of COVID-19.

EXPERT OPINION:

In my opinion, the rationale for undertaking a trial of lopinavir/ritonavir in COVID-19 was poor. The analysis of a modified intention to treat group analysis in LOTUS China may have introduced bias. After LOTUS China, there is probably no future for lopinavir in the treatment of severe COVID-19, but some clinical trials for prevention or in various stages of COVID-19 have recently started or are ongoing. The major limitation of these trials is that as lopinavir does not inhibit COVID-19, it is unlikely to prevent infection, reduce viral load, or reduce the severity. However, these trials may be worthwhile in finally determining whether lopinavir has any role in preventing or treating COVID-19.

• Authors: Sheila A Doggrell
• Journal: Expert opinion on investigational drugs (Expert Opin Investig Drugs) Vol. 29 Issue 8 Pg. 793-796 (Aug 2020) ISSN: 1744-7658 [Electronic] England
• PMID: 32475183 (Publication Type: Journal Article)

Chemical References

• Antiviral Agents
• Drug Combinations
• lopinavir-ritonavir drug combination
• Lopinavir
• Ritonavir

Topics

• Antiviral Agents (administration & dosage, pharmacology)
• COVID-19
• Coronavirus Infections (drug therapy, virology)
• Drug Combinations
• Humans
• Lopinavir (administration & dosage, pharmacology)
• Pandemics
• Pneumonia, Viral (drug therapy, virology)
• Randomized Controlled Trials as Topic
• Ritonavir (administration & dosage, pharmacology)
• Severity of Illness Index
• Treatment Outcome
• Viral Load (drug effects)
• COVID-19 Drug Treatment