Talk:COVID-19 drug development/Archive 1

Archive 1

Proposed merge of COVID-19 vaccine with COVID-19 drug development

The following discussion is an archived record of a request for comment. Please do not modify it. No further edits should be made to this discussion. A summary of the conclusions reached follows.

There is a clear consensus below that the COVID-19 vaccine article should remain as separate.(non-admin closure) --Zefr (talk) 19:07, 27 March 2020 (UTC)

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This page contains some copied material from COVID-19 vaccine and the two cover virtually the same thing. Sam-2727 (talk) 17:12, 21 March 2020 (UTC)

• Oppose, they are definitely not "virtually the same thing", as drug development is focused on therapeutics to be administered to people who have the disease, and vaccine development is focused on a distinct class of preventative biologics for people who do not have the disease. Put in a "see also" section or a {{See main}} template, but there is a reason that every vaccine developed thus far has its own article in Wikipedia separate and distinct from articles on drugs for treatment of the condition. BD2412 T 17:19, 21 March 2020 (UTC)
• Oppose I think it's pretty clear that vaccines and therapeutic drugs are different subjects. However, I think there's some distinction to be made between the development of novel drugs for COVID-19 treatment, and drug repurposing research. Pretty recently I've started the COVID-19 Drug Repurposing Research page since it's a distinct line of research in drug development. I think a good solution might be making a general page for drug development that links out to the different research directions like Drug Repurposing. ProbablyAndrewKuznetsov (talk) 18:43, 21 March 2020 (UTC)
• Comment If we're talking about therapeutic drugs here, why not move to COVID-19 treatment development? Username⁶⁸⁹² 18:44, 21 March 2020 (UTC)
  • I would consider that a reasonable solution. BD2412 T 18:59, 21 March 2020 (UTC)
  • +1 This makes sense to me ProbablyAndrewKuznetsov (talk) 19:36, 21 March 2020 (UTC)
  • +1 This page is about both vaccines and therapeutics. Specific pages for each also exist COVID-19 vaccine and COVID-19 drug repurposing research <- probably should be renamed to COVID-19 drug development --Gtoffoletto (talk) 22:08, 21 March 2020 (UTC)
  • To disease scientists, vaccines are "biologics" and antivirals are "therapeutics" or "medicines", but to the general public encyclopedia user (and apparently to Anthony Fauci when answering media questions), vaccines and antivirals both are "drugs" tested in the conventional drug development process; hence, the title given to this article. We should use a title that facilitates a public seeking information and is consistent with common non-medical search terms. I don't think 'treatment' would be searched much. --Zefr (talk) 23:38, 21 March 2020 (UTC)
    • If the general public thought whales were a kind of fish, we would still make the distinction. Whatever the name of this article, a "see also" to an article specifically focused on the vaccine is still merited. There is no question that there will, in very short order, be an enormous amount of content on that topic, as on this one. BD2412 T 23:43, 21 March 2020 (UTC)
• Oppose but the if the articles are to remain seperate the copied (now out of date) content on vaccines on this page should be removed. Currently due to this copied content the articles are in effect already merged. --D Wells (talk) 13:06, 22 March 2020 (UTC)
• Comment I won't !vote on this because I don't know enough about the difference, but it might be helpful to put a {{see also}}, {{for}}, or {{distinguish}} at the top of both pages. — Gestrid (talk) 07:33, 23 March 2020 (UTC)
• Oppose It is better to have separate article for drug development regarding COVID-19 and officially we haven't got any information about the invention of the vaccine and the practical tests are still ongoing. Abishe (talk) 16:31, 23 March 2020 (UTC)

• It seems prudent that it should be a single page and should include both vaccine and drug development in a single page, and include both in the title. One implies immunization, the other implies treatment. As a researcher and academic, I would find it very useful to have it on a single page. ChristensenKH (talk) 19:42, 22 March 2020 (UTC) — ChristensenKH (talk • contribs) has made few or no other edits outside this topic.
• Both on a Single Page Vaccine development and Treatment development are two separate things. However, I believe it should both be on a single page with a title like "COVID-19 Vaccine & Treatment Development." I agree with ChristensenKH, it would be very helpful and useful to be on the same page. DustyGoliath (talk) 20:27, 23 March 2020 (UTC) — DustyGoliath (talk • contribs) has made few or no other edits outside this topic.
• Oppose: as many have said before, there is a difference between developing a vaccine and developing a treatment. I will say that the drug development article needs to be more clear that it is referring only to treatment. It should not include stuff about potential vaccine.  Bait30  ^{Talk 2 me pls?} 20:53, 23 March 2020 (UTC)
• Keep vaccine separate Doc James (talk · contribs · email) 05:17, 24 March 2020 (UTC)
• Oppose since they have very different modes of operation, development and use. Graeme Bartlett (talk) 11:02, 24 March 2020 (UTC)
• Oppose Not the same thing, with a clear disamb. header I think researchers will have no problems finding the article they are looking for Sugarcoils (talk) 11:43, 24 March 2020 (UTC)

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

inhibitors

thanks for your edit @Zefr:, here. for my taste this was slightly too much deletion. the scientific article alone seems a little harsh for mere mortals. as well it lacks the context why this stuff is important: to have a spray which prevents that the virus let itself clone. it does not prevent a virus can infect a cell. i would love to add it again - that is "inhibit" if i understood it correctly? --ThurnerRupert (talk) 09:39, 29 March 2020 (UTC)

ThurnerRupert: The freedesktop link makes little sense to me. I found your edit too complex and over-discussed for the general user, so tried to keep the presentation general (see WP:NOTJOURNAL 6-8). Keeping the inhibitors discussion explained simply, as in this and this pertaining to the Solidarity trial, will serve the article adequately, as it stands now, in my opinion. --Zefr (talk) 20:06, 29 March 2020 (UTC)

Heads up, FDA has just issued Emergency Use Authorization (EUA) for Chloroquine,Hydroxychloroquine

Amidst concerns about its effectiveness from scientists, FDA has just issued Emergency Use Authorization (EUA) for Chloroquine (and Hydroxychloroquine). We should import some information from there. Thanks everyone. https://www.fda.gov/emergency-preparedness-and-response/mcm-legal-regulatory-and-policy-framework/emergency-use-authorization#2019-ncov ProbablyAndrewKuznetsov (talk) 15:48, 30 March 2020 (UTC)

Tracking Phase II trial starts: what to list?

There's another Phase II trial now in progress, APN01. I'd add it to the article myself, but I know next to nothing about this topic, so I'd prefer it if someone else could do it; I'm not even sure what the criteria are for when to add individual Phase II trials to this page. —Nightstallion 09:18, 2 April 2020 (UTC)

Nightstallion - We have the first three Phase II trials testing preliminary efficacy against COVID-19 infection listed as bullet points under Other compounds, but there are 85 total treatment candidates in development at different stages, as of 30 March - the Apeiron trial is listed there as #73 (Ctrl F, search "Apeiron"). In the coming weeks/months, many more Phase II trials for COVID-19 treatment candidates will begin. However, a caveat from this report: Phase II Trials in Drug Development and Adaptive Trial Design: "phase II is a poor predictor of drug success: > 30% of drugs entering phase II studies fail to progress, and > 58% of drugs go on to fail in phase III." In simple terms from that source, 88% of drug candidates entering Phase II trials will not get approved. My interpretation is that we should have a skeptical view about COVID-19 treatment candidates entering Phase II trials - because 9/10 of them will fail - and so these should not be tracked in this article as encyclopedic content. We should focus our attention on the Phase III candidates, covered here and in the progress of the SOLIDARITY trial. That's my personal view; others may dispute it. --Zefr (talk) 14:59, 3 April 2020 (UTC)

COVID-19 Clinical Research Coalition

Published 2 April in The Lancet: Global coalition to accelerate COVID-19 clinical research in resource-limited settings. As of late March, 536 COVID-19 clinical studies in progress. --Zefr (talk) 16:39, 3 April 2020 (UTC)

Merge from COVID-19 drug repurposing research

The following discussion is an archived record of a request for comment. Please do not modify it. No further edits should be made to this discussion. A summary of the conclusions reached follows.

There is a clear consensus that the articles should be merged. --Guerillero | Parlez Moi 15:58, 7 April 2020 (UTC)

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These two pages basically cover the same thing. Yes the vaccine article should be kept separate. Doc James (talk · contribs · email) 05:17, 24 March 2020 (UTC)

• Agree: yes, we should merege it with special categories to these two since this is the same topic [[User:Andreiii3213|Andreiii3213))(talk) 11:49, 24 March 2020 (UTC+1)
• Agree Sugarcoils (talk) 11:01, 24 March 2020 (UTC)
• Support as most of the proposed drugs are repurpose ones. Graeme Bartlett (talk) 11:03, 24 March 2020 (UTC)
• Support Important subsection of COVID-19 Drug Development, can be spun out later if it gets way longer and drug development significantly deviates from drug repurposing.ProbablyAndrewKuznetsov (talk) 18:29, 24 March 2020 (UTC)
• Agree --Kabutops7 (talk) 22:26, 24 March 2020 (UTC)
• Agree: The two topics are strongly related and will ease research. 97.122.202.63 (talk) 18:38, 27 March 2020 (UTC)
• Agree Content overlaps. David notMD (talk) 21:19, 27 March 2020 (UTC)
• Agree --ThurnerRupert (talk) 09:39, 29 March 2020 (UTC)
• Alternative solution: The article on COVID-19 drug repurposing research has merit as it exists to explain individual repurpose drug candidates, their approved uses and mechanisms, and to tabulate their progress toward Phase III trials for COVID-19. My impression is that incorporating the entire article into this one would make tedious reading for non-medical encyclopedia users (see WP:NOTJOURNAL #6-8). The WHO Solidarity trial has identified 4 potential treatment therapies as Phase II-III studies in COVID-19 infections, and that international effort will likely be the fastest standard for other clinical research centers to follow (such as the INSERM "Discovery" trials). I suggest 1) using a general summary of the repurpose drug candidates in Phase III testing to be used to introduce "drug repurposing" above the discussion for the Solidarity trial (some repurpose drugs potentially for treating COVID-19 infection will have to begin at Phase IIA, so that earlier stage of research could be detailed in the Repurposing article and table, and 2) that we focus the "drug development" article mainly to the Phase III repurpose candidates. Meanwhile, I added the new section here. --Zefr (talk) 19:47, 29 March 2020 (UTC)

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

I'm sorry for commenting on a sealed discussion but I agree with Zefr's proposal above. It's not drug "development", it's repurposing. We can't make up new names for it when the term is widely used in medical and scientific publications. If this content is going to be merged it should not be by dumping off-topic content into random sections and leaving it for others to fix. Zefr's proposal takes into account the existing structure of this article. Gammapearls (talk) 05:57, 8 April 2020 (UTC)

I agree with Gammapearls' revert and with re-establishing the repurposed drug research article. --Zefr (talk) 15:42, 8 April 2020 (UTC)

What specifically is the difference between "drug development" and "drug repurposing", and which drugs are in each category? I notice that a lot of drugs are currently discussed in both articles. If the articles are to remain split, each drug should be discussed only in one article to prevent redundant content forking. John P. Sadowski (NIOSH) (talk) 22:52, 8 April 2020 (UTC)

Definitions for the two terms are described clearly in the article. Repurposing approved drugs for a new indication like COVID-19 infection by conducting clinical trials is a method of drug development (also clearly explained). I don't feel we should be concerned at this point about overlap in the two articles, as both appear to be serving encyclopedia users: the two articles are < 3 weeks old, but have attracted > 130,000 page views, and are thoroughly linked across WP COVID-19 topics. There will be trial results and new developments soon that will give clearer views on differentiating them. --Zefr (talk) 23:32, 8 April 2020 (UTC)

These articles still need to comply with WP:REDUNDANTFORK and WP:SUMMARY if they are to remain separate. For example, chloroquine is clearly a repurposed drug, so the text discussing it should be in the repurposing article, with at most a short summary here. This article should only have an in-depth discussion of drugs that are not repurposed, otherwise it is confusing for readers, and hard to maintain. John P. Sadowski (NIOSH) (talk) 04:31, 9 April 2020 (UTC)

Tofacitinib/Xeljanz

This article's structure is so confusing I do not know where to add info about Tofacitinib/Xeljanz, probably something like this: "Laboratory research suggests Tofacitinib (Xeljanz) blocks SARS-CoV-2 from replicating, and experimental testing on patients is to begin in summer 2020, with some Italian patients getting the drug in April." Source. Thanks, WikiHannibal (talk) 14:27, 9 April 2020 (UTC)

Ways to improve the article's organization for clarity would be welcomed here on the talk page, but there have been content and organization disputes and changes that now disrupt clarity in the article, as shown above in these talk discussions and in the article history.

Under the subhead "Phase III-IV trials" are the statements: Numerous candidate drugs under study as "supportive" treatments to relieve discomfort during illness, such as NSAIDs or bronchodilators, are not included in the table below. Others in early-stage Phase II trials, such as BDB-1, brilacidin, and APN01, or numerous treatment candidates in Phase I trials, are also excluded. Drug candidates in Phase II trials have a low success rate (under 12%) for eventual approval. The intent here was not to track everything in early-stage development - that is more news, WP:NOTNEWS and is maintained on a 2x-weekly tracker here, now listing 103 candidates in preclinical or clinical development (April 7) where tofacitinib is not included yet because it is still in the lab, and will take months at best to develop for Phase I studies. Most of the candidates in Phase I-II trials are likely to fail. Zefr (talk) 16:21, 9 April 2020 (UTC)

Folding@Home research

Folding@Home is a distributed computing project, oriented towards medical research. They recently put efforts in simulating molecule folding to help elaborate treatment candidates for COVID-19. Since these are efforts for a future COVID-19 drug, I think it should be mentioned in the article, maybe near the "Efforts to streamline drug discovery" section, and/or in the "See also" section. — Preceding unsigned comment added by DevBowman (talk • contribs) 23:05, 9 April 2020 (UTC)

Support - I think Foldit should be consired too, since they are also putting efforts in the discover of new antiviral drugs that might stop COVID-19: https://fold.it/portal/node/2008963. Saung Tadashi (talk) 08:35, 10 April 2020 (UTC)

Nitric oxide

Was shown effective at treating SARS according to at least one study and is currently under investigation as inhaled coronavirus therapy. It's still at phase II however, so I'm not adding it yet. buidhe 23:38, 10 April 2020 (UTC)

References

Nothing about Vitamin C ?

• Carr, A. C. (2020). A new clinical trial to test high-dose vitamin C in patients with COVID-19. Critical Care, 24(1), 1-2. https://ccforum.biomedcentral.com/articles/10.1186/s13054-020-02851-4
• Erol, A. (2020). High-dose intravenous vitamin C treatment for COVID-19. https://osf.io/p7ex8/download?format=pdf
• doi:10.1001/jama.2019.11825 — Preceding unsigned comment added by Lamiot (talk • contribs) 19:52, 11 April 2020 (UTC)

The safe and potent compound against SARS cov2 in preclinical model

I'd to say that COVID-19 is not untreatable health challenge. Drug treatment requires real efforts by researchers within the context of rapid repurposing and development of an approved drug against COVID-19 viral proteins. My research team had published a preclinical research (in LPMA. Preprocessing of the candidate antiviral drugs against COVID-19 models of SARS cov2 targets) in which 20 compounds were assessed for their coronavirus target binding energy. Of the most effective inhibitors was a tripeptide compound with wide spectrum of safety (GT). I submitted a project to adopt this compound as a trial for those patients with critical COVID-19.

Thank you Hussein Wik (talk) 03:53, 15 April 2020 (UTC)

Article focus

The original intent for this article was to keep a focus on the candidate drugs in pivotal Phase III-IV trials that will provide quick yes-or-no answers for treating COVID-19 infections, and to describe the process and growing global support to expedite pivotal trials during the pandemic. Other editors may disagree, but my instinct is to leave candidates in development stages earlier than Phase III out of the article (too many to describe and track for progress over the coming weeks/months). Let good trackers like the weekly Milken Inst report keep the tab on pre-Phase III progress. Note: a new drug candidate in the lab is still called a "new chemical entity (NCE, not a drug)", until it has been approved first as an IND to allow human studies, and does not become an actual "drug" until successful Phase III-IV trials when it is given NDA designation (New Drug Application) for marketing in the US. Repurposed COVID-19 drug candidates will each have an NDA, if successful, as a new prescription for treating infections.

We now have a "Therapeutics candidates" section (which should focus on the Phase III-IV trials) and a "COVID-19 drug candidates" section (which should be retitled as "Early-stage COVID-19 drug candidates" and provide information on pre-Phase III development of the NCE-IND). But this latter section is where listing individual candidates, including the hidden table, seems futile because most will fail, persuading that such a section be brief, defer to COVID-19 treatment candidate trackers, and present only the highlights of candidates approaching Phase III trials. --Zefr (talk) 17:17, 9 April 2020 (UTC)

If the goal of this article is to discuss only phase III-IV trials, then the article title needs to be changed, since "drug development" includes all phases from pre-clinical on. Also, since most or all of the phase III drugs are repurposed, shouldn't they be discussed in the drug repurposing article and not here? I agree with dividing up drugs by their clinical trial phase, but that's impossible as long as there's a separate article on repurposed drugs. John P. Sadowski (NIOSH) (talk) 01:05, 10 April 2020 (UTC)

For now it should be enough to include a a brief summary in this article with a link to the more detailed article. We can see again in a few weeks if it makes sense to combine or split some sections into the other article.Gammapearls (talk) 01:55, 10 April 2020 (UTC)

I still don't see how either of you plan to reduce the redundancy between content in the two articles. The merge proposal passed overwhelmingly and with significant participation, so immediately reverting the merge was the wrong thing to do. I don't see any proposal here that's different from what was already rejected. John P. Sadowski (NIOSH) (talk) 21:07, 10 April 2020 (UTC)

I see no grievous harm in allowing the two articles to mature before addressing merge or not again, especially as each provides a mention of the other. David notMD (talk) 00:19, 11 April 2020 (UTC)

I mean you can't just ignore the consensus because you disagree. Start a new RFC if you would like --Guerillero | Parlez Moi 13:30, 15 April 2020 (UTC)

Remdesivir

Yesterday I pointed out that the mechanism of action of Remdesivir mentioned in the table of this article differs from the Wikipedia article about Remdesivir. My comment was removed as original research and personal insult. I find this slightly strange.--2001:14BB:431:20F:D864:AC27:238A:ED72 (talk) 11:30, 16 April 2020 (UTC)

 Done - Zefr (talk) 14:06, 16 April 2020 (UTC)

Milken Institute tracker and other clinical trial updates

The Milken Institute has - as best as I can see - the most frequently updated (at least 2x/week) tracker for all COVID-19-related treatment and vaccine candidates, a report that had been a somewhat awkward PDF for the past weeks, but is now a dynamic Google spreadsheet, today's version shown here. Presuming it enables viewing of updates in real time, the Milken tracker will be a "live" update source going forward. Wondering what other editors think about using this as a source for tracking progress of drugs in late-stage clinical trials (and earlier stages), as it is still awkward to use on a cell phone (or even a widescreen desktop), and its sources are hidden behind another click, but I think it's a substantial resource for keeping an eye on progress. For comparison, the next-best sources are either "draft landscape" reports from WHO (too many of which are dead links under "Therapeutics"), and occasional tracking reports, such as this one by Canadian scientists in the April 24th Lancet, proposing real-time tracking of therapeutic research underway using a diagram to aggregate and display various potential therapeutics here. The Lancet authors mention the new COVID-19 literature tracker from the US National Library of Medicine, called "LitCovid", shown here. Background on why this is relevant, WP:NOW. Zefr (talk) 15:26, 26 April 2020 (UTC)

• @Zefr: I agree with what you are trying to do and the intent here. I support your idea because I think this is achievable through routine Wikipedia activity. At the same time, this idea is difficult because it requires developing multiple complicated and experimental projects. While we can have steady advancement toward these goals, accomplishing this would be bumpy and take a group of very friendly experienced Wikipedia editors collaborating over time. There is Wikidata:Wikidata:WikiProject COVID-19 to discuss datasets on this disease. Also, few people are participating, but I am trying to organize Wikidata:Wikidata:Clinical Trials, and if you want to join me there, then yes, we can curate all the clinical trials on COVID. There are only 600 registered in the United States so this is a human-manageable number. For partnering with external organizations, this is so complicated, but meta:Wiki Project Med Foundation is a legal entity which can facilitate some parts of a partnership when external organizations demand to speak with an established Wikipedia organization, which is an almost universal request in any partnership. Real time tracking is on the table but in my view the biggest problem with this is having no infrastructure for documentation or quality control. Distinguishing between 1 day, month, or year out of date in Wikidata is a big challenge. If you want to talk about any of this ping me in Wikidata for a more focused discussion on any subtopic in your proposal. Blue Rasberry (talk) 18:12, 26 April 2020 (UTC)

New section on computing research?

Hello all,

I contributed the section "Supercomputer-assisted research" to the page COVID-19 vaccine a while back, with work on the Summit supercomputer and Blue Waters having piqued my interest. I relied extensively on press releases and news articles for sourcing, however; the sources contained no indication of vaccine research, but rather were focused on the discovery of drug candidates, forecasting, and medical protocols. Therefore, the section was removed. (I highly recommend going over the version history for the page.)

If I may ask, where might any information on the effects of COVID-19 on computing research be located? More pertinently, as other users have pointed out to me, would it be most acceptable to add a section here? Jarrod Baniqued (talk) 02:00, 27 April 2020 (UTC)

@Jarrod Baniqued: without seeing it, I think it would be appropriate in this article, or perhaps even it's own. Do you have the text userified? Or is it only in the vaccine article history? - Scarpy (talk) 21:11, 28 April 2020 (UTC)

I did put it under drug discovery at first, then to a more fitting subsection. I don't know what "userifying" means exactly. Jarrod Baniqued (talk) 21:17, 28 April 2020 (UTC)

Userfying just means that you have the text somewhere in your userspace, like in your sandbox. BD2412 T 21:44, 28 April 2020 (UTC)

I see. I did not userify it. I usually get by well enough without the sandbox or other user features. Glad to hear from you! Jarrod Baniqued (talk) 07:52, 10 May 2020 (UTC)

Semi-protected edit request on 14 May 2020

Xulian Hongkong (talk) 23:28, 14 May 2020 (UTC)

Till now, some antibacterial drugs were tested against SARS-CoV-2 and showed activity such as Azithromycin but no previous trials were done using the antifungal medications and while bacterial and fungal share in the structure of SARS-CoV-2 . , it is recommended to start trials with a triple therapy consist of antiviral (e.g. Remdesivir) + antibacterial (e.g. Aithromycin) + antifungal (e.g. fluorocytosine and/or Micafungin) medications. also the ability of virus to form a biofilm as well as the melanogenic activity of SARS-CoV-2 should be deeply stuided. Detect lactose intolerance as risk factor for COVID-19 disease as lactose intolerance test for patients should be processed in order to find out this risk factor which might be a useful diagnostic test to investigate the vulnerability to infection for healthy people and others who have risk factors such as compromised immunity or chronic diseases

 Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format and provide a reliable source if appropriate. RandomCanadian (talk | contribs) 23:30, 14 May 2020 (UTC)

Zinc addition as possible treatment

Zinc addition is missing on the page and I think it should be added after recent study release showing initial favorable/promising results. see link https://www.barrons.com/news/zinc-hydroxychloroquine-found-effective-in-some-covid-19-patients-study-01589234407 — Preceding unsigned comment added by Berkshires (talk • contribs) 21:57, 12 May 2020 (UTC)

That's primary, inconclusive research and more news than meaningful content; WP:NOTNEWS. We'll need to wait to see if this is confirmed in several clinical trials of hospitalized people with COVID-19, then a WP:MEDRS review published in a reputable journal. Also note that zinc is a dietary mineral (also here), not a vitamin. Zefr (talk) 22:46, 14 May 2020 (UTC)

You are tight that this is primary study. However this is the only study that has been released on this combo, and with showing a 44% decline in mortality this is definitely an important development which should be on this page. — Preceding unsigned comment added by Berkshires (talk • contribs) 22:57, 14 May 2020 (UTC)

Remember to sign and timestamp your talk page comments by typing four tildes. The finding is interesting and potentially important, but there is no conclusive review in a reputable medical journal giving confidence for the importance of zinc in treating COVID-19. See PMID 32334392 which shows the absence of certainty. Zefr (talk) 23:13, 14 May 2020 (UTC)

With all due respect, NYU is one of the leading hospitals in US treating covid-19 cases in the US, the study covered 932 patients which is pretty solid size. While not clinical trial, there is not a single study released yet showing this combo "not" to be helpful, while there is alot of anecdotal evidence that it is helpful. To avoid an edit war i would propose the following language.

On 8 May, NYU Hospital released a retrospective observational study from 932 covid-19 patints treated during March-April at the NYU hospital. The results showing that patients who had the miniral zinc added to their hydroxychloroquine/azithromycin combo, saw a 44% reduction in mortality versus those receiving hydroxychloroquine and azithromycin alone. This study provided the first in vivo evidence that zinc sulfate in combination with hydroxychloroquine may play a role in therapeutic management for COVID-19. The authors of the study emphasize that this is retrospective observational study, and not a clinical trial.

The above makes it pretty clear that its not conclusive at all, but in fact the results seem to be promising. Ignoring does not sound reasonable--Berkshires (talk) 23:39, 14 May 2020 (UTC)

This is an as of yet a WP:PRIMARY study which has not been independently confirmed. MEDRS applies, this probably does not go in unless there is more suitable sourcing available. Wikipedia is not a newspaper, we don't need to and shouldn't report every latest unconfirmed finding. RandomCanadian (talk | contribs) 00:17, 15 May 2020 (UTC)

Will get some more suitable sourcingBerkshires (talk) 00:27, 15 May 2020 (UTC)

@Berkshires: Suitable sourcing would require that a reliable peer-reviewed publication (to name the most well-known ones, Nature or Science, but of course there are plenty of other ones) publish a review article on the topic. Given that the primary study you mention was published 6 days ago, that is almost certainly not enough time for that to have happened (nor for other studies to have been undertaken to verify this finding)... RandomCanadian (talk | contribs) 00:31, 15 May 2020 (UTC)

See link below from science direct relating to this combo.

There seems to be growing evidence that this triple combo works. Your position that as long there is no peer reviewed study/publication it should not be mentioned on Wikipedia even as a potential option to is quite unreasonable. Especially when this whole virus is new.

On Wikipedia the way its now, someone would not be aware that this combo exists when looking on all potential treatment options studied. In fact there are clinical trials going on all over the world for this combo.

I have not interest in edit war, just want it to be on record.

https://www.sciencedirect.com/science/article/pii/S0306987720306435?via%3Dihub — Preceding unsigned comment added by Berkshires (talk • contribs) 20:47, 15 May 2020 (UTC)

@Berkshires: It's not my opinion. It's Wikipedia policy: this is not a breaking news website, nor a resource for people to look up the latest developments; but an encyclopedia. We only report things (especially in medical matters) when there is sufficient coverage in adequate reliable sources - in this case the guideline is WP:MEDRS; and there is no problem with waiting until medical experts have taken the time to verify this hypothetical treatment. In any case, WP is much more rapidly updated than traditional encyclopedias...Oh and please sign you comments using ~~~~; there's even a button to do so "Sign your posts on talk pages". Thanks, RandomCanadian (talk | contribs) 00:11, 16 May 2020 (UTC)

Another distributed computing project

About two weeks ago, the World Community Grid started a COVID-19 research project with Scripps Research called OpenPandemics. While the WCG is pretty notable, it's not as widely known in the media as Folding@home, and its COVID project launch didn't receive nearly as much attention as Folding@home. I was only able to find a single ZDNet article, most of the other sources were either closely associated with the project or seemed kind of bloggy.

Would this be enough to establish sufficient notability and verifiability for a mention to be included in the article? --Veikk0.ma 08:58, 30 May 2020 (UTC)

We already have this section under drug discovery. Seems it could be added there as another source if unique enough. Zefr (talk) 14:51, 30 May 2020 (UTC)

Alpha-ketoamides?

So, I just found an interesting paper that used molecular simulations to find potential SARS-CoV-2 treatments, and which found that alpha-ketoamides should be explored as one. This isn't my area of expertise, so I'd like to get the thoughts of more experienced contributors. MiasmaEternal^TALK 05:46, 22 June 2020 (UTC)

Semi-protected edit request on 21 June 2020

Add the following sentence under "Favipravir" header:

In June 2020, India approved the use of a generic version of favipravir called FabiFlu, developed by Glenmark Pharmaceuticals, in the treatment of mild to moderate cases of COVID-19. 59.95.71.196 (talk) 16:20, 21 June 2020 (UTC)

 Done ~ Amkgp 💬 15:27, 30 June 2020 (UTC)

References

Aviptadil?

I see no mention of aviptadil. Here's an article from a Houston news station.

Houston Methodist reports rapid recovery of critically ill COVID-19 patients with new drug

I'm not really a big expert on medicine. If anyone thinks adding this treatment is warranted, please add it to the article. FunksBrother (talk) 18:39, 10 August 2020 (UTC)

Leronlimab should be included

Leronlimab is the only drug I am aware of that has shown statistically significant positive results in a double-blind placebo-controlled clinical trial. It has also shown amazing results in critically ill patients as referenced in the paper below. If it is approved by the FDA this may be "the" treatment for COVID-19.

Here is a proposed entry:

Table:

COVID‑19: candidate drug treatments in Phase III–IV trials
Drug candidate	Description	Existing disease approval	Trial sponsor(s)	Location(s)	Expected results	Notes, references
Leronlimab	humanized monoclonal antibody against interleukin-5 receptor	New drug candidate	CytoDyn	Multiple sites in the United States	August/September 2020	Aug 15 - Phase 2 mild/moderate study unblinded and preliminary results positive Severe/Critical phase 2b/3 study ongoing and enrolling

Listing: |- | Leronlimab || colspan="2" | A drug originally developed to treat HIV. On May 5, 2020 a pre-print paper indicated that leronlimab had a significant effect in the 10 critically ill COVID-19 patients studied. This discovery led to a phase 2 study for mild to moderate COVID-19 patients and a Phase 2b/3 study for severe or critical COVID-19 patients. On June 18th. 2020, Dr. Bruce Patterson, M.D. described his research involving the method of action of leronlimab in COVID-19 patients at a TEDx talk. On August 11, 2020 both clinically significant primary endpoint results and statistically significant secondary endpoint results were released from the unblinded mild to moderate phase 2 study. Based on the study results CytoDyn applied for emergency use authorization (EUA) from the US FDA for the treatment of COVID-19.

References

For now, we have the section on Early-stage COVID‑19 drug candidates: Preliminary clinical research: Phase II trials where individual drugs possibly useful for treating severe COVID-19 infection are not listed. PRO 140 (leronlimab) is a monoclonal antibody drug, which is generally included as a potential therapeutic platform in the article. It impresses me as too early to include it in the main Ph III table. Also, let's not cite press releases from sponsor companies (CytoDyn) which are typically WP:PLUG-enthusiastic and promotional. Clinicialtrials.gov reports two small Ph II studies are underway, and there are no PubMed reviews on the use of leronlimab for treating COVID-19 infection. Zefr (talk) 20:33, 14 August 2020 (UTC)

Thanks for your response. I think there is some confusion. Hopefully, this is useful:

1. A monoclonal antibody (mab) is a large class of biologics used to treat disease. "We already list mabs so we don't need any specific ones listed" would be similar to saying "we already list 'drugs' as a class of treatment for headaches so we are not going to separately include aspirin in the list." Leronlimab is a type of mab that does not directly affect a virus. It binds receptors (CCR5) in the inflammation pathway preventing the runaway inflammation seen in the complications of COVID-19 and other diseases. You are correct that many of the mabs are binding the virus and basically behave as normal anti-disease antibodies, but this one is quite different. Leronlimab acts more like a traditional drug, but because it is an antibody it is highly specific about what it binds to. In theory (and in practice so far) it should have far fewer side effects than drugs that perform similar actions. It's a fascinating field of medicine.
2. I think there is some confusion about the FDA approval process. Normally, a drug will go through a Phase 1, 2, and then 3 clinical trial, apply for a BLA or NDA and possibly conduct a Phase 4 study after approval or upon conditional approval. In the current situation, many drugs that have already shown safety and efficacy in past Phase 3 trials (like Remdesivir) will skip Phase 1 and Phase 2 trials and will go right to a Phase 3 trial or in Leronlimab's case have a Phase 2 or Phase 2b/3 trial. Leronlimab has successfully completed its mild to moderate Phase 2 trial and one likely option for the FDA is immediate approval under the "unmet medical need" pathway. Another option is to ask for a short Phase 3 trial. Leronlimab is also in a Phase 3 trial that based on the previous trials and safety review last week will either soon be stopped because it has met its endpoints early or be allowed to complete in about a month. I think you can agree that Leronlimab is a treatment that is at the late stages of approval given that there is a not unlikely chance the FDA will approve it in the next few days. Do you know of any other treatments that have successfully completed a Phase 2 trial or are likely to show results from a Phase 3 trial in a few weeks? Here is the approval process for reference. While there might not be PubMed publications about Leronlimab for COVID-19 treatment (the Patterson et al paper is the only one I am aware of) there are currently 29 Leronlimab papers in PubMed
3. Normally, I would agree with you that a press release is hardly reliable information and has no place in reference material not focusing on the release itself. As I am sure you are aware, papers generally take weeks to months to write and months to years to be peer reviewed. Right now, that time-frame has (for better or worse) been compressed, but it still takes a significant amount of time. In this case the drug has already completed Phase 3 trials for another disease, the medicine is incredibly fast moving and the data was just released from the statisticians a few days ago. It is the best information now, but the reference should be changed when published research is available. Because this is potentially a list used by researchers looking for collaboration, I felt it was more important to link to their PR claims (especially since they listed the endpoint and the p-value for it) than to leave the information out.

--TwoCandlesInTheDark (talk) 21:54, 14 August 2020 (UTC)

References

Thanks for your explanation. I have no confusion. We are not a news site or a comprehensive tracker of possible therapeutics for COVID-19. The Clinicaltrials.gov site I gave above is an adequate source for showing leronlimab in two Ph II trials, far from an interventional Ph III trial needed for proof of efficacy against COVID-19 disease. If you are affiliated in any way with CytoDyn, you have to declare potential WP:COI on your talk page. Zefr (talk) 22:46, 14 August 2020 (UTC)

I think I understand the underlying issue. The top of the severe/critical study says "Phase 2". Further down in the "Official Title" it says "Phase 2b/3". You are assuming it is Phase 2 and I didn't notice the discrepancy until now. Fair enough. Either there is a mistake in the official title/description or there is a mistake in the "Phase" section. Can you find any sources that say it is only a Phase 2 study? The company and medical doctors discussing it are calling it a Phase 2b/3 study. I am genuinely interested. I have encouraged others to look into these trials for treatment and I would like to have the most accurate information.

While we are discussing changes, here are a few drugs that should probably be removed from the "candidate drug treatments in Phase III–IV trials" list:

1. Favipiravir failed to meet its endpoints
2. ASC-09 + ritonavir was not in a Phase 3 study as far as I can tell
3. Sarilumab trial was ended early because it didn't meet its end points
4. This isn't exhaustive. I just looked at the drugs/biologics that seemed out of place.

Here are a few drugs/biologics in Phase 3 studies that I found while checking the list above:

1. Opaganib
2. LY-CoV555
3. Baricitinib
4. Also not exhaustive.

I am a new editor, but I am not a sock puppet. Nobody asked me, paid me, or influenced me to contribute to this or any other Wikipedia article. I am going to generously assume that you were asking me what my motivation was for contributing to Wikipedia. I found Leronlimab when researching COVID-19 treatments and have been stunned by both it's apparent effectiveness and how often the company, the drug, and people mentioning it have been subjected to ad hominem attacks. I want to provide the most accurate information about the drug and the company so that everyone can benefit from it. I hope that someone with access to better or more timely information will see my contributions and build on them. I respect the foundations of Wikipedia and want it to be the best repository of knowledge possible. I encourage people to question the science and I welcome data that disproves any assertions I might make.

--TwoCandlesInTheDark (talk) 01:20, 15 August 2020 (UTC)

Thanks for pushing me to do more research. I was able to confirm the trial results from a third party and find an inaccuracy in the trial reference for HIV. I am also more confident that the "phase" box at clinicaltrials.gov is a typo and the "Official Title" is correct. I found four sources referring to the severe/critical Leronlimab study as a combined Phase 2b and 3 study:

1. Targeted Onclolgy article about the leronlimab trials
2. May 11, 2020 edition of TrialSite News
3. Precision Vaccinations article "Fact checked by Robert Carlson, MD"
4. The 2019-2020 CytoDyn annual report filed yesterday with the US Securities and Exchange Commission mentions the Phase 2b/3 COVID-19 study on pages 7, 10, 58, 61, and 116.

I updated the suggested snippet at the top to remove the links to the press releases, fixed the link to the completed phase 3 clinical trial for HIV, tried to use more neutral language, added a TEDx talk about the leronlimab COVID-19 study given by one of the researchers (worth checking out if you aren't familiar with CCR5), removed the press-release-sourced safety data, and added a proposed "COVID-19: candidate drug treatments in Phase III–IV trials" table entry. If any editor would like to revise the entry above before including it, please feel free.

--TwoCandlesInTheDark (talk) 06:16, 16 August 2020 (UTC)

References

The trial is called an "adaptive design" (in the article here), meaning its parameters will change as Phase II results become known. I'm not convinced that it is yet a Phase III trial that should be included in the table, as more data (and a peer-reviewed publication) are needed to qualify for the Phase III. For WP:CON, it's usually best to allow other editors (or to recruit them here for discussion) to have input before making a disputed change to the article. Zefr (talk) 16:13, 16 August 2020 (UTC)

The link you provided refers to the "Adaptive COVID-19 Treatment Trial (ACTT)". These trials are clearly labeled on clinicaltrials.gov. For example, here is the trial for remdesivir and the trial for rem/baricitinib. I cannot find any evidence that the leronlimab trial is part of ACTT, ACTT-2, or ACTT-3. Here are three other trials that are phase 2b/3 and also unrelated to ACTT. The "adaptive design" phrase refers to the ability of the sponsor to modify parameters of the study during the trial in a phase 2b/3 trial (referred to as "adaptive seamless phase II/III trial design" in the linked article). Can you find any evidence that there is a delineation between phase 2b and phase 3 in a combined study? Phases_of_clinical_research#Summary refers to both Phase 3 and combined Phase 2/3 studies as "late phase studies." In the context of this page I don't see the difference between an adaptive phase 2b/3 trial and a phase 3 trial. After reviewing the reference above, do you see a difference?

As far as a peer-reviewed publication is concerned, can you please provide links to the peer-reviewed publications corresponding to the other therapeutics in the list. I couldn't find one for many of them. It seems counter-productive to require a peer-reviewed publication for therapeutics that are in development for a recently discovered disease. This requirement is likely to eliminate therapeutics from companies without a large staff of clinicians, extensive university connections, and graduate students who can produce papers and peer review in a fraction of the time normally required. I appreciate your input and have benefited from it. If this content isn't appropriate for this page, I don't have a problem with that. It would help me to know how it is inconsistent with the current content so I do not make a similar mistake in the future. I invited another editor to take a look. Thanks for making that suggestion. --TwoCandlesInTheDark (talk) 05:07, 17 August 2020 (UTC)

3.1.5 Chloroquine and hydroxychloroquine

It is worth noting that the 2 studies mentioned which showed lack of efficacy were both on hospitalised patients (i.e. severe SARS-Cov2 already at peak viral load), as for whether it is affective as a preventative is yet to be determined. Cdjknu (talk) 09:01, 5 October 2020 (UTC)

Fusion proteins

It might well be worth addressing the topic of fusion proteins, in case some of the authors of this article have knowledge of the topic. See for example:

• Bernardi A, Huang Y, Harris B, Xiong Y, Nandi S, McDonald KA, Faller R (2020). "Development and simulation of fully glycosylated molecular models of ACE2-Fc fusion proteins and their interaction with the SARS-CoV-2 spike protein binding domain". Plos One. 15 (8): e0237295. doi:10.1371/journal.pone.0237295. PMC 7406073. PMID 32756606.{{cite journal}}: CS1 maint: unflagged free DOI (link)
• Innovative SARS-CoV-2 Blocker from Formycon Completely Prevents Infection of Cells, DGAP-News, press release, 9 December 2020.
• Efficient inhibition of SARS-CoV-2 strains by a novel ACE2-IgG4-Fc fusion protein with a stabilized hinge region, bioarxiv.org, preprint, 11 December 2020, DOI 10.1101/2020.12.06.413443.

Thank you. --Chris Howard (talk) 09:31, 18 December 2020 (UTC)

We'd need some WP:MEDRS. Is there any? Alexbrn (talk) 09:33, 18 December 2020 (UTC)

I've made the suggestion but unfortunately do not have the expert knowledge in this field to be able to provide background information or to suggest appropriate resources. I do think somebody else may know much more about this than I do. --Chris Howard (talk) 10:36, 18 December 2020 (UTC)

Where does Vitamin-D fit in?

I am trying to figure out why Vitamin-D is not featured on this page on the other similar one COVID-19 drug repurposing research.

There is a surprising amount of research on the go with trials and published papers. Safety at physiological doses is well proven yet widespread deficiencies remain uncorrected. Demonstrated benefits and learned consensus keeps telling us that it should be on the front line as a prophylactic to minimise severity even it it does nothing else.

Here is a secondary source of sorts that has valuable information in the conclusion. Vitamin D and COVID-19: evidence and recommendations for supplementation

Here are some of the published study results Vitamin D is effective for COVID-19: real-time meta analysis of 37 studies

Has this simply been forgotten or what is the reason it is a second class citizen to new drugs that have still to be invented?

Idyllic press (talk) 21:17, 17 January 2021 (UTC)

There's some coverage at Misinformation related to the COVID-19 pandemic#Vitamins. Alexbrn (talk) 21:23, 17 January 2021 (UTC)

Molnupiravir

Of all the wonders shown to beat this dreadful disease, there's one drug that should be given a mention in this article... molnupiravir. According to this, it stops transmission of COVID-19 in 24 hours and interesting, by its own article here, it's found to stop transmission of SARS and MERS too. I know it's currently an experimental drug and who knows when it can be rolled out to the public, I just want to know if it can be added to this article or not. Bryn89 (talk) 09:57, 22 January 2021 (UTC)

WP:MEDRS quality sourcing would be needed. Alexbrn (talk) 10:13, 22 January 2021 (UTC)

Promising new Israeli therapeutic

Still early days (only a 30-patient sample), but looking good! Ref: "New Israeli Covid drug which cured 30 cases of disease hailed by scientists as 'huge breakthrough'" (The Daily Telegraph). El_C 23:32, 5 February 2021 (UTC)

Update: Prof. Nadir's revolutionary new therapeutic said to have 97 percent efficacy rate! Ref: "Israeli Coronavirus Treatment Cures 97% of Patients" (2-minute video courtesy of i24 News). El_C 02:39, 9 February 2021 (UTC)

Pfizer pill worth watching

Sources:

• Pfizer is now testing a COVID-19 pill - The Hill
• Pfizer begins early stage clinical trial testing oral antiviral drug for Covid - CNBC
• Pfizer Begins Human Trials of New Pill to Treat Coronavirus - Bloomberg
• Drug is called "PF-07321332". Entering phase I trials. Hopefully, even more successful than Remdesivir! --Chillabit (talk) 03:33, 24 March 2021 (UTC)

Emergency use authorization for VIR-7831 (GSK4182136)

VIR-7831 & GSK4182136, COVID-19 antibody therapies by Vir Biotechnology & GlaxoSmithKline.
[1][2][3][4][5]
for news search: VIR-7831 EUA. 0mtwb9gd5wx (talk) 21:08, 31 March 2021 (UTC)

Still just news, WP:NOTNEWS, as the EUA application was submitted only days ago, meaning VIR-7831 is not yet approved. Zefr (talk) 22:13, 31 March 2021 (UTC)

Semi-protected edit request on 24 May 2021

To add to the table of candidates (COVID‑19: candidate drug treatments in Phase III–IV trials)

Drug candidate: Apabetalone

Description: selective BET inhibitor

Existing disease approval: investigational

Trial sponsor(s): Resverlogix Corp

Location(s): United States

Expected results: March 22, 2022

Notes, references:

"An Open-Label Study of Apabetalone in Covid Infection". NIH National Library of Medicine. May 20, 2021. Retrieved May 24, 2021.

"Milken Institute Covid-19 Tracker". May 20, 2021. Retrieved May 24, 2021. Jonzobot (talk) 19:46, 24 May 2021 (UTC)

 Done TGHL ↗ 🍁 20:09, 24 May 2021 (UTC)

COVID-19 pills being tested?

Seems several "3C-like protease inhibitors" (such as "PF-00835231", "PF-07304814" and "PF-07321332") may be under consideration as possible drugs to treat the "COVID-19 disease" - QUESTION: is the following reference worth adding to the main article? - in any case - Stay Safe and Healthy !! - Drbogdan (talk) 19:59, 1 June 2021 (UTC)

References

News (06/02/2021) worth considering?

Recent news (06/02/2021) worth considering for the main article? - iac - Stay Safe and Healthy !! - Drbogdan (talk) 00:25, 3 June 2021 (UTC)

References

Semi-protected edit request on 13 July 2021

In the hatnote, change "For a potential COVID-19 vaccine, see COVID-19 vaccine. " to "For COVID-19 vaccines, see COVID-19 vaccine. " 50.30.176.52 (talk) 20:24, 13 July 2021 (UTC)

 Done. Zefr (talk) 21:54, 13 July 2021 (UTC)

A Commons file used on this page or its Wikidata item has been nominated for deletion

The following Wikimedia Commons file used on this page or its Wikidata item has been nominated for deletion:

• PF-07321332 structure.png

Participate in the deletion discussion at the nomination page. —Community Tech bot (talk) 14:38, 15 July 2021 (UTC)

Molnupiravir

This article currently doesn't mention molnupiravir, which was today approved for therapeutic use in the UK.I've edited the molnupiravir article but I'm unfamiliar with how things are done in these more specific COVID-19 related articles. Can someone else incorporate this information in the correct way? Mike Turnbull (talk) 12:13, 4 November 2021 (UTC)