Stock markets fell today after a promising drug that experts hoped would become a breakthrough treatment for coronavirus flopped in its first key trial.
The FTSE 100 index of Britain’s largest companies finished the day down by 74 points or 1.28 per cent at 5,752 – while the Dow Jones in the US also dipped slightly by 26 points or 0.11 per cent to 23,490.
Investors had high hopes that remdesivir – an anti-viral drug originally developed for Ebola – would prove to be an effective treatment against Covid-19.
But that optimism was reversed last night when a more important study – the first randomised clinical trial for the drug – showed it had no impact on the disease.
Draft documents published accidentally by the World Health Organisation showed it did not improve patients’ condition or even cut levels of the virus in the blood.
According to the manuscript the drug also caused significant side effects, meaning 18 of 158 patients had to be taken off the treatment.
California-based Gilead said the findings were inconclusive because the study was terminated early but investors said the market was ‘rattled’.
And it insisted the study was abandoned because it only recruited 237 participants and was ‘underpowered to enable statistically meaningful conclusions’.
The FTSE 100 index dropped today following a rollercoaster fortnight, as displayed above
Questions were today raised over three other promising drugs, including one touted by the US President Donald Trump as a ‘game changer’.
Experts found the death rate was twice as high in patients given hydroxychloroquine – branded as Plaquenil, compared to those given no medication.
Two other drugs, HIV combination lopinavir/ritonavir and an antiviral called Arbidol, had no effect on hospitalised patients, according to a separate study.
Market sensitivity to news related to a COVID-19 cure reflected traders’ desperation for a sign of when the global economy might start returning to normal.
Tim Ghriskey, chief investment strategist at New York-based wealth management firm Inverness Counsel, said: ‘Any piece of bad news is likely to rattle the market.
‘Investors are keen for a semblance of hope that they can soon crawl out of their homes and get on with some form of normal life, even if with trepidation and fear.’
A vial of the drug Remdesivir is seen at a press conference in Hamburg, Germany on April 8
In the US, the S&P 500 and the Nasdaq turned negative at the close yesterday.
WHAT IS REMDESIVIR?
Remdesivir was developed around 10 years ago with the intention of it destroying the Ebola virus. It was pushed aside, however, when other, better candidates emerged.
It’s made by California-based pharmaceutical company Gilead Sciences, the firm behind the life-changing HIV-preventing pill Truvada, or PrEP. Because it is only an experimental drug, it doesn’t have a marketed name.
Lab tests of remdesivir have shown promise against coronaviruses – but human trials are still in their early days.
Doctors in the US have tried it on patients and it managed to speed up the recovery of the first person to be treated for the virus there.
The a 35-year-old man in Washington state, close to Seattle – whose infection was announced on January 20 – recovered after being given the drug.
A Californian woman who doctors ‘thought was going to pass away’ also recovered in the US after being given the drug.
Four American passengers on board the Diamond Princess cruise ship treated with the drug in Japan also recovered.
Officials in Liguria – a coastal region of Italy – also announced an infected man in his 70s had recovered and could go home after 12 days in hospital.
It is not prescribed on the NHS because it hasn’t been approved.
Hundreds of patients – including some in the UK – taking part in a European mega-trial will get chance to take the drug to prove if it can fight the coronavirus.
The drug is also being trialled on coronavirus patients in China and at the University of Nebraska.
Scientists are full of hope because the drug is proven to be safe in humans. But its side effects are still not well understood.
Professor Devi Sridhar, chair of global public health at the University of Edinburgh, hailed remdesivir as ‘one of the most promising antivirals’ being investigated.
While Dr Alfredo Garzino-Demo, of the University of Maryland School of Medicine, said evidence shows it has the ability to treat COVID-19 patients.
Francois Savary, Prime Partners chief investment officer, said: ‘Its a negative session. The market for the last week has been under consolidation after a strong rally.
‘A lot of good news has already been priced in and news that the number of deaths had increased in the US was also a warning sign for investors.’
Gilead shares fell more than 4 per cent after the data was inadvertently released and first reported by the Financial Times.
No drugs have yet been proven to treat COVID-19, and scientists are in a desperate race against time to find a vaccine that works.
Doctors have been desperate for anything that may alter the course of the disease, which has infected more than 2.7million people worldwide.
Remdesivir was thrust into the limelight in January when the WHO listed it as ‘the most promising candidate’ for a COVID-19 therapy.
Trials have shown the medication can fight against SARS and MERS, cousins of the new coronavirus, in the lab and on animals.
Scientists say remdesivir – which is also being trialled in scores of British hospitals – could have a ‘profound impact’ on the global pandemic.
But the new results have dealt a blow the hopes of scientists desperate to have their COVID-19 arsenal bolstered.
A screenshot of the WHO posting, captured by STAT News, said the trial enrolled 237 patients with 158 receiving remdesivir compared with 79 who got a placebo.
The rate of death was similar at 13.9 per cent for remdesivir, versus 12.8 per cent in the control group – suggesting the drug made little difference.
The final paper is now undergoing peer review – the process that allows scientists to scrutinise the work of fellow academics and point out crucial flaws.
A WHO spokesperson said that UN-agency was waiting for a ‘final version’ before it would comment on the data.
STAT reports that, according to the summary of the China study, remdesivir was ‘not associated with a difference in time to clinical improvement’.
Gilead disputed reports that remdesivir failed to help patients patients with severe cases of the novel coronavirus, scientifically called SARS-CoV-2.
It said the WHO’s post included inappropriate characterizations of the study, which was terminated early due to low enrollment.
‘We regret that the WHO prematurely posted information regarding the study, which has since been removed,’ a spokesperson told CNBC.
The headquarters of Gilead Sciences are pictured at Foster City in California on April 17
They also added that the investigators in the study did not provide permission for publication of results. It is unclear who led the trial.
REMDESIVIR PREVENTS CORONAVIRUS MERS IN MONKEYS
Remdesivir was recently shown to prevent disease and reduce the severity of symptoms in monkeys infected with MERS, an infection closely related to SARS-CoV-2.
The results, reported in Proceedings of the National Academy of Sciences in February, raised hope that it could be effective against the new coronavirus virus.
‘It wasn’t successful in Ebola, but there is some indication that it might be successful in the coronaviruses,’ Dr. Anthony Fauci, director of the US National Institute on Allergy and Infectious Diseases (NIAID), said in a recent interview.
NIAID scientists tested remdesivir in monkeys 24 hours prior to infection with MERS and in other monkeys 12 hours after infection – the time frame in monkeys when the virus is most active.
They were compared with untreated monkeys in a control group. After six days, all of the untreated animals got sick.
In the monkeys treated prior to infection, the drug appeared to prevent disease. Animals in this group showed no sign of infection, had significantly lower levels of virus in their lungs and no lung damage.
Those treated after infection also fared better than the control group. They had less severe disease, their lungs had lower levels of virus and they had less severe lung damage, researchers found.
Many drugs that succeed in monkeys fail in humans.
Nevertheless, the researchers said their findings bolster hopes for the ongoing studies in China and for compassionate use of the drug in severely ill patients.
Gilead also said that trends in the data suggest a potential benefit for remdesivir, ‘particularly among patients treated early in disease’.
Despite Gilead stating that the results were ‘inconclusive,’ some financial analysts drew conclusions anyway.
Raymond James’ Steven Seedhouse said the data will ‘drive the prevailing view’ that remdesivir ‘isn’t working’ in critically-ill patients.
Doctors have speculated that an antiviral drug like remdesivir would likely be most effective when administered as early as possible in the course of the disease.
Remdesivir is an anti-viral drug that works by crippling the RNA polymerase enzyme, stopping a virus from reproducing in the blood.
It is an experimental drug that has been in the making for 10 years – but it has yet to be approved to treat any condition.
Originally it was developed for Ebola but it was found to have no effect during the outbreak in the Democratic Republic of Congo last summer.
The first COVID-19 patient diagnosed in the US reportedly improved overnight after doctors gave the 35-year-old remdesivir as a last-ditch attempt to treat him.
The man, from Washington, was given it when his condition worsened, according to a report in the New England Journal of Medicine (NEJM).
Another Californian who doctors thought might not survive also made a recovery with remdesivir, medics claimed last month.
Gilead is testing remdesivir in multiple trials, with results from a study involving 400 patients hospitalized with severe COVID-19 expected later this month.
Expectations for that trial may now be dampened somewhat by the leaked data from the Chinese study.
A separate trial in China testing the drug in patients with more moderate symptoms last week was also suspended due to a lack of eligible patients.
The ‘Fearless Girl’ statue wears a face mask with US flags outside the New York Stock Exchange on Wall Street yesterday
The news comes days after another report detailed the rapid recovery in fever and respiratory symptoms in some patients with COVID-19.
PROMISING HIV DRUGS AND AN ANTIVIRAL ‘HAVE LITTLE EFFECT’
Hopes for a coronavirus cure were dealt a blow today after promising HIV drugs and an anti-viral were shown to have little effect on infected patients in China.
Patients given lopinavir/ritonavir or Arbidol did not improve any quicker than those treated without drugs in the study of 86 patients.
Sufferers given the antivirals also reported side effects including diarrhoea, nausea, and loss of appetite.
The researchers recommend for this reason the drugs should not be used as a COVID-19 therapy.
However, they only looked at patients with mild-to-moderate cases of the infection and say the outcome may be different for people with critical illness.
Lopinavir/ritonavir (LPV/r) and Arbidol were earmarked as two of the most promising treatments for coronavirus after lab studies showed they stopped coronavirus from replicating.
The latest study, by the Centre for Infectious Diseases of Guangzhou Eighth People’s Hospital in Guangzhou, split 86 patients into three groups.
Thirty-four volunteers were randomly assigned to get lopinavir/ritonavir, 35 were given Arbidol, and 17 received supportive care as a control.
All three groups showed similar outcomes after a week and 14 days. The study found no differences between groups in the rates of fever reduction, cough alleviation, or improvement of lung inflammation.
University of Chicago Medicine recruited 125 people with COVID-19 as part of global clinical trials. Of those people, 113 had severe disease.
Most of the patients have been discharged after their symptoms eased over a week, and only two patients have died.
Gilead saw its shares surge by 16 per cent in after hours trading as American stock markets rallied overnight in response to the encouraging trial results.
The paper’s author called the findings ‘hopeful,’ but said it was difficult to interpret the results since they do not include comparison to a control group.
The University of Chicago is one of 152 locations participating in Gilead’s phase three clinical trial involving severe COVID-19 patients, with other locations in the UK.
Other remdesivir results were published in the NEJM earlier this month, with one infectious disease specialist calling them ‘encouraging’.
More than half of a group of 53 severely ill COVID-19 patients – aged between 23 and 82 – improved after receiving the drug, according to the trial.
All of the patients had been admitted to hospital in the US, Europe, Canada or Japan. Thirty-four were sick enough to require breathing machines.
All were given the drug through an IV for 10 days or as long as they tolerated it. But there was no control group to compare the results against.
Thirty-six patients, or 68 per cent, needed less oxygen or breathing support after 18 days, on average. Eight others worsened.
Seven patients died, nearly all of them over age 70. A dozen had serious problems but it was not clear whether they were from the drug or their disease.
Side effects included septic shock and trouble with kidneys and other organs. Four discontinued treatment because of health problems they developed.
COVID-19 PATIENTS TREATED WITH MALARIA DRUG TOUTED BY TRUMP ARE MORE LIKELY TO DIE, STUDY FINDS
More US veterans sickened by coronavirus who were treated with the malaria drug President Trump touted for treating the disease died than did patients who were given the usual supportive care, a new study reveals.
And the results suggested that the drug, hydroxychloroquine, provided no benefit to the patients who received it.
The nationwide study was not a rigorous experiment. But with 368 patients, it´s the largest look so far of hydroxychloroquine with or without the antibiotic azithromycin for COVID-19, which has killed more than 182,000 people as of Tuesday.
The study was posted on an online site for researchers and has has not been reviewed by other scientists. Grants from the National Institutes of Health (NIH) and the University of Virginia paid for the work.
Meanwhile, the a panel of experts assembled by the NIH also issued recommendations against the use of hydroxychloroquine with the antibiotic to treat COVID-19 on Tuesday, citing concerns over toxicity.
Researchers analyzed medical records of 368 male veterans hospitalized with confirmed coronavirus infection at Veterans Health Administration medical centers who died or were discharged by April 11.
About 28 percent who were given hydroxychloroquine plus usual care died, versus 11 percent of those getting routine care alone.
About 22 percent of those getting the drug plus azithromycin died too, but the difference between that group and usual care was not considered large enough to rule out other factors that could have affected survival.
Some critical care doctors agreed the recovery rate was promising but one said there is ‘no way of knowing from this series if remdesivir was helpful’.
EU leaders agreed yesterday to build a trillion euro emergency fund to help recover from the coronavirus pandemic but leaving divisive details until the summer.
French President Emmanuel Macron said EU governments still disagreed over whether the fund should be transferring grant money, or simply making loans.
Alain Durre at Goldman Sachs said: ‘The risk exists that a concrete decision on the creation of the recovery fund may not occur before September, thereby not being operational before early 2021.’
US business activity fell to record lows in April, mirroring dire figures from Europe as stay-at-home orders crushed production, supply chains and consumer spending.
The US House of Representatives yesterday passed a $484billion bill to expand federal loans to small businesses and hospitals overwhelmed by patients.
President Donald Trump, who has indicated he will sign the bill, said last night that he may need to extend social distancing guidelines to early summer.
In Japan, shares in the Nikkei stock index slid 0.84 per cent amid lingering concern about the spread of infections before the Golden Week public holidays.
Shares in South Korea, which has won recognition for its aggressive measures to contain the coronavirus, fell 1.11 per cent. Australian shares bucked the trend, rising 0.71 per cent due to gains in the energy and resources sector.
Oil prices extended a tentative rebound from a price collapse this week that pushed US crude futures into negative for the first time ever.
But investors remain concerned about weak energy demand and excess supplies of crude. US crude ticked up 4.85 per cent to $17.30 a barrel.
The outlook remains dim because global energy demand has evaporated due to business closures and travel curbs aimed at slowing the pandemic. In addition, some countries are running out of space to store the crude oil that they are not using.