en
Scientific article
Review
Open access
English

The fragmented COVID-19 therapeutics research landscape : a living systematic review of clinical trial registrations evaluating priority pharmacological interventions [version 1; peer review: 1 approved, 1 not approved]

Published inWellcome open research, vol. 7, 24
Publication date2022-01-25
First online date2022-01-25
Abstract

Background: Many available medicines have been evaluated as potential repurposed treatments for coronavirus disease 2019 (COVID-19). We summarise the registered study landscape for 32 priority pharmacological treatments identified following consultation with external experts of the COVID-19 Clinical Research Coalition.

Methods: All eligible trial registry records identified by systematic searches of the World Health Organisation International Clinical Trials Registry Platform as of 26 th May 2021 were reviewed and extracted. A descriptive summary of study characteristics was performed.

Results: We identified 1,314 registered studies that included at least one of the 32 priority pharmacological interventions. The majority (1,043, 79%) were randomised controlled trials (RCTs). The sample size of the RCTs identified was typically small (median (25 th , 75 th percentile) sample size = 140 patients (70, 383)), i.e. individually powered only to show very large effects. The most extensively evaluated medicine was hydroxychloroquine (418 registered studies). Other widely studied interventions were convalescent plasma (n=208), ritonavir (n=189) usually combined with lopinavir (n=181), and azithromycin (n=147). Very few RCTs planned to recruit participants in low-income countries (n=14; 1.3%). A minority of studies (348, 26%) indicated a willingness to share individual participant data. The living systematic review data are available at https://iddo.cognitive.city

Conclusions: There are many registered studies planning to evaluate available medicines as potential repurposed treatments of COVID-19. Most of these planned studies are small, and therefore substantially underpowered for most relevant endpoints. Very few are large enough to have any chance of providing enough convincing evidence to change policies and practices. The sharing of individual participant data (IPD) from these studies would allow pooled IPD meta-analyses which could generate definitive conclusions, but most registered studies did not indicate that they were willing to share their data.

eng
Keywords
  • COVID-19
  • SARS2-CoV2
  • Coronavirus
  • Clinical trials
  • Emerging infections
  • Trial registries
  • Living systematic review
Citation (ISO format)
MCLEAN, Alistair R.D. et al. The fragmented COVID-19 therapeutics research landscape : a living systematic review of clinical trial registrations evaluating priority pharmacological interventions [version 1; peer review: 1 approved, 1 not approved]. In: Wellcome open research, 2022, vol. 7, p. 24. doi: 10.12688/wellcomeopenres.17284.1
Main files (1)
Article (Published version)
Identifiers
ISSN of the journal2398-502X
12views
2downloads

Technical informations

Creation04/17/2024 9:17:00 AM
First validation07/22/2024 7:16:20 AM
Update time07/22/2024 7:16:20 AM
Status update07/22/2024 7:16:20 AM
Last indexation07/22/2024 7:16:40 AM
All rights reserved by Archive ouverte UNIGE and the University of GenevaunigeBlack