HIV medications lopinavir and ritonavir (LPVR), in combination, are currently being investigated as a proposed COVID-19 treatment. The potential mechanism of action of LPVR is that it may disrupt the replication and spread of the severe acute respiratory syndrome coronavirus 2 — or SARS-CoV-2 — within the body. However, there is uncertainty around the clinical effectiveness of LPVR in patients with COVID-19. CADTH reviewed and summarized the evidence regarding the clinical effectiveness of lopinavir-ritonavir for the treatment and prevention of COVID-19.

On October 15, 2020, interim study results from the World Health Organization’s Solidarity Trial were released in pre-print (ISRCTN83971151). The Solidarity Trial is a large, international, adaptive, open-label, randomized controlled trial launched by the World Health Organization and other partners to evaluate several treatments for COVID-19. The interim results report on the findings of four separate treatments compared with local standard of care in hospitalized patients with COVID-19: remdesivir, lopinavir and ritonavir, interferon beta-1a, and hydroxychloroquine. The primary outcome was in-hospital mortality. The intention-to-treat analyses included 11,255 patients enrolled from 405 hospitals in 30 countries, including Canada. No treatment had a statistically significant reduction in 28-day in-hospital mortality compared with its control. Caution should be exercised in interpreting any interim study results. In addition, pre-print reports have not been peer-reviewed. Publication of full study results in a peer-reviewed journal are pending.

The findings of the Solidarity Trial do not change the overall conclusions of CADTH’s Health Technology Review on lopinavir and ritonavir in the treatment of COVID-19.

Link to Report

Lopinavir-Ritonavir for the Treatment and Prevention of COVID-19: A Review of Clinical Effectiveness

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