The university hospital of Besançon, Dijon and 18 more hospitals to participate. The project Discovery aims to test at european level and the effectiveness of 4 treatments already known about patients forms severe Covid-19. Among them, the now famous chloroquine which is so much about it.
Discovery what is it ?
In Burgundy and Franche-Comté, the university hospital of Dijon and Besançon are the 2 institutions involved. The clinical trial Discovery, it is a european project involving France, Belgium, the netherlands, Luxembourg, the United Kingdom, Germany and Spain. The objective is to test the effectiveness on the coronavirus Covid-19 of 4 treatments already known and used for other diseases.
In France, the test Discovery must include at least 800 patients in twenty hospitals. The project is headed by Professor Florence Ader, the department of infectious diseases and tropical of the civil Hospices of Lyon and researcher at CIRI, international Center for research in infectiology.
“This is a test of extreme importance, details Professor Lionel Piroth, the one of the two to coordinate the project at the CHU of Dijon. It is intended to determine if, among the treatments that are supposed to have an activity on the coronavirus, there is one that stands out as being the best possible option”
The famous Chloroquine and other molecules…
4 experimental treatments are tested. “These molecules are known for the most part for a very long timesaid Professor Piroth. “But none has yet demonstrated its effectiveness in infection with Coronavirus in humans.”
What are these molecules ?
- The remdesivir : It is a molecule that is usually used in the treatment against Ebola. Testing in-vitro and in animals have proved encouraging in the context of the Covid-19.
- Lopinavir/Ritonavir : It is an anti-HIV known since a score of year, but “that is not simple to use,” warns the Pr. Piroth
- The combination of lopinavir/ritonavir + interferon : Interferon is a molecule used in the treatment of multiple sclerosis to stimulate the immune system. It will be tested in addition to the Anti-HIV.
- Hydroxychloroquine : The chloroquine to the more familiar. Everyone is talking about since the statements of professor Didier Raoult in Marseille, france. This treatment is usually used for some diseases, auto-immune or in some form, in the preventive treatment against malaria.
A fifth treatment option now, the usual management of patients is provided, without any of these molecules. “None of them has demonstrated effectiveness so far, we can not say that they are better than the current way of taking care of the sick “ says Professor Piroth. The aim is to compare the situation of the sick in which one of the 4 treatments applied to other patients with the Covid-19.
“The list of these potential drugs is also based on the list of experimental treatments designated as high priority by the World Health Organization” explains the INSERM in a connections.
What are the patients involved ?
In France, at least 800 patients severe must participate in the clinical trial. At Besançon, the objective is, for example, to include a thirty by mid-April. So how are they chosen ?
“ It is a scientific trial “ prevents first of all the Pr Piroth. “In order for its results to be interpretable, it is necessary that neither the doctors nor the patients do not choose treatment’. The attribution of one of 5 treatment options is done so by random draw.
Eventually, the CHU of Dijon, the test may include more patients than expected due to the significant number of voluntary patients. “It has an acceptance rate important and a mobilisation of all the teams of the CHU. We should include maybe a little more sick than what was expected. “
Why reserve this test to patients with the most serious ?
“These treatments all have side effects” warns professor Piroth. “The acceptance of the adverse effects will be all the more large that the patient’s condition is serious. The major part of the patients who are going to do a infection Covid will heal spontaneously. Why make them undergo treatment, to side effects while they are going to heal ? “
The analysis of the effectiveness and safety of treatment will be assessed 15 days after inclusion of each patient details of the INSERM. Then, everything will depend on the state of health of the patients. Some people will therefore remain longer if their state does not improve.
When will be known the findings of the trial Discovery ?
“In theory, the results will be known in a very long time. ” It will take several months for the results of all patients in each country are analyzed and compared. For the moment, France is the only country to have implemented this therapeutic trial on the first patients diagnosed with the coronavirus.
“Very quickly the experimental treatments ineffective can be abandoned and replaced by other molecules’ – Pr Florence Ader
But in practice, the first lessons could be learned a bit faster. “The analysis of the effectiveness and safety of treatment will be assessed 15 days after inclusion of each patient,” explains the INSERM, which puts forward a test “adaptive”. “Very quickly the experimental treatments ineffective can be abandoned and replaced by other molecules which will emerge from the research. We can therefore respond in real-time, in consistency with the latest scientific evidence, to highlight the best treatment for our patients “, analysis Professor Florence Ader, Lyon.
“The more people are included soon [dans l’essai clinique], soon more will be obtained from the results more quickly and will be drawn conclusions for the practice of care “ hope the Pr Piroth.
“If you include very quickly of patients, as is the case for France, you could have the results much sooner than what one could expect initially. “
Another test world baptized Solidarity and co-ordinated by the World Health Organization (WHO) is also launched. Discovery associated with it. It should help to bring other data forward professor.
Watch the full interview with Professor Lionel Piroth :
Interview with Professor Lionel Piroth / Project discovery Coronavirus
©Anne Berger, Amelie, The Douay / France Télévisions