Publications by authors named "Simon Boyd"
Evidence that remdesivir treatment reduces viral titers in patients with COVID-19.
Antimicrob Agents Chemother
December 2024
Article Synopsis
- Antiviral drugs are crucial in preventing severe outcomes from COVID-19, and measuring the clearance of SARS-CoV-2 in patients helps assess their effectiveness.
- A meta-analysis of data from the PLATCOV trial focused on how viral clearance rates change over time in patients to improve the design of future antiviral drug evaluations.
- The study found that effective antiviral interventions speed up the initial phase of viral clearance, with the best results observed within the first five days after treatment begins.
Background: Effective antiviral drugs accelerate viral clearance in acute COVID-19 infections; the relationship between accelerating viral clearance and reducing severe clinical outcomes is unclear.
Methods: A systematic review was conducted of randomized controlled trials (RCTs) of antiviral therapies in early symptomatic COVID-19, where viral clearance data were available. Treatment benefit was defined clinically as the relative risk of hospitalization/death during follow-up (≥14 days), and virologically as the SARS-CoV-2 viral clearance rate ratio (VCRR).
Unlabelled: In early symptomatic COVID-19 treatment, high dose oral favipiravir did not accelerate viral clearance.
Background: Favipiravir, an anti-influenza drug, has in vitro antiviral activity against SARS-CoV-2. Clinical trial evidence to date is inconclusive.
Article Synopsis
- - The ongoing PLATCOV trial compares the antiviral effects of molnupiravir and ritonavir-boosted nirmatrelvir in treating early symptomatic COVID-19 patients across various countries including Thailand and Brazil, using viral clearance as the main measure of effectiveness.
- - In this phase 2, open-label trial, low-risk adults aged 18-50 with COVID-19 symptoms were randomly assigned to one of seven treatment groups, including both antiviral drugs and a no-drug control group, ensuring at least 20% of participants received no medication.
- - The study assesses the rate of viral clearance and treatment safety over one week using a Bayesian model to evaluate the effectiveness of the antiviral treatments, aiming to establish if either
Background: Uncertainty over the therapeutic benefit of parenteral remdesivir in coronavirus disease 2019 (COVID-19) has resulted in varying treatment guidelines.
Methods: In a multicenter open-label, controlled, adaptive, pharmacometric platform trial, low-risk adult patients with early symptomatic COVID-19 were randomized to 1 of 8 treatment arms including intravenous remdesivir (200 mg followed by 100 mg daily for 5 days) or no study drug. The primary outcome was the rate of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) clearance (estimated under a linear model fit to the daily log10 viral densities, days 0-7) in standardized duplicate oropharyngeal swab eluates, in a modified intention-to-treat population.
Background: There is no generally accepted methodology for in vivo assessment of antiviral activity in SARS-CoV-2 infections. Ivermectin has been recommended widely as a treatment of COVID-19, but whether it has clinically significant antiviral activity in vivo is uncertain.
Methods: In a multicentre open label, randomized, controlled adaptive platform trial, adult patients with early symptomatic COVID-19 were randomized to one of six treatment arms including high-dose oral ivermectin (600 µg/kg daily for 7 days), the monoclonal antibodies casirivimab and imdevimab (600 mg/600 mg), and no study drug.