Investigating Treatment Options

By Dr. Dennis Killian, Vice President, Clinical Operations

As we continue to deal with the global SARS-CoV-2 pandemic (COVID-19), many researchers and clinicians are rapidly searching for effective treatment options.

At this time, there is no conclusive evidence regarding any treatment option. There are many controlled, randomized clinical trials in progress to fully understand the benefits and risks associated with therapeutic options for COVID-19.

This article will highlight a small handful of COVID-19 treatment options that are currently under investigation. These include: 

Dr. Dennis Killian

Chloroquine or Hydroxychloroquine: Older, FDA-approved compounds originally indicated to treat malaria. Hydroxychloroquine exhibits less toxicity than chloroquine and is commonly used in the treatment of autoimmune diseases, such as lupus and rheumatoid arthritis. A small French study showed promise when oral hydroxychloroquine was combined with oral azithromycin (Zithromax; Z-Pak). There have been anecdotal reports of therapeutic success with this combination. Additional recent studies with small sample sizes have shown no benefit from this same medication combination.

Remdesivir: Non-FDA-approved medication manufactured by Gilead Pharmaceuticals and currently in Phase III trials. This medication is administered intravenously and is thought to work by inhibiting viral RNA polymerase, thereby inhibiting viral replication. Availability is limited to existing research protocols or compassionate use only. Preliminary clinical trial data appears promising.

Tocilizumab (Actemra): FDA-approved monoclonal antibody primarily used for rheumatoid arthritis. Works by inhibiting interleukin-6, which is thought to decrease effects associated with “cytokine storm,” which is immune system hyperactivity in some COVID-19 patients. The primary route of administration is intravenous.

Convalescence plasma: Investigational therapy involving plasma from individuals who have recovered from COVID-19. The hypothesis is that the antibodies from these patients will confer clinical benefit to infected patients.

Vaccine development for COVID-19 is underway by multiple companies across the globe. Even though rapid progress has been made thus far, experts estimate that a vaccine release for public use will not occur for 12 to 18 months. One company, the Boston-based biotech firm Moderna, started Phase I trials in humans on March 16, which is the fastest vaccine development ever seen. Their vaccine uses a piece of genetic material from COVID-19, mRNA, to elicit an immune response in patients. The timeline for vaccine development is long because researchers want to be certain the vaccine is not only effective but has limited side effects. We are still trying to understand other important aspects of COVID-19 that may impact vaccine production, such as RNA mutations and patient immunity to COVID-19 after infection.

Dr. Dennis Killian graduated from the University of Maryland-Baltimore School of Pharmacy and was the first student to complete the Pharm.D. (1999), Ph.D. (2001) dual-degree pathway at this institution. He currently serves as the vice president of Clinical Operations at Peninsula Regional Health System, where he has been employed since 2004. To learn more about COVID-19 and the health system’s response to the virus, visit peninsula.org/covid.