Finding new treatments
Finding out what works
Since the start of the pandemic, we have funded and supported the delivery of a range of research into potential COVID-19 treatments.
These fast-tracked, prioritised COVID-19 studies have placed the UK at the forefront of global efforts to establish effective treatments against the disease.
Within months of the first NIHR-supported urgent public health studies opening, UK researchers had published evidence to establish the world’s first proven treatments for patients with COVID-19.
This incredible feat of science could not have been achieved without the research infrastructure and expertise provided by the NIHR, working closely alongside the NHS and devolved nations. This support enabled a wide range of studies to be set up at hospitals across the UK, at unprecedented pace and scale.
Just months after recruiting the first participant, the RECOVERY trial proved that dexamethasone reduced the risk of dying by one third, in ventilated patients. The discovery that a cheap and widely available steroid could benefit seriously ill patients was a major breakthrough, resulting in the world's first life-saving COVID-19 treatment. In March 2021, NHS England published figures that showed the use of dexamethasone had already saved 22,000 lives in the UK and an estimated one million worldwide.
REMAP-CAP also showed that a seven-day course of hydrocortisone led to improved survival rates, and reduced the need for intensive care support for seriously ill patients with COVID-19.
As a result, dexamethasone and hydrocortisone are now used as treatments for hospitalised COVID-19 patients, not only by the NHS, but also many other countries across the world.
REMAP-CAP also showed that two existing anti-inflammatory drugs commonly used to treat arthritis; tocilizumab and sarilumab, can cut deaths by a quarter amongst the most seriously ill COVID-19 patients. Researchers found that these drugs can also reduce the average length of hospital stay for critically ill patients, and speed up recovery time.
Preliminary results from an NIHR-supported phase 2 trial into SNG001, an inhaled respiratory treatment, show that participants had a 79% lower risk of developing severe disease compared to placebo. We are now supporting a much larger phase 3 trial into SNG001, which is taking place at hospitals across the country. This is in addition to a community-based study, where the treatment is taken by less seriously ill patients, at home.
As part of an international trial delivered in the UK through the NIHR, the antiviral drug remdesivir was also shown to be clinically effective in the treatment of patients with severe COVID-19, reducing the recovery time of participants. Following this, remdesivir is now used as a treatment within the NHS, and around the world.
Possible antibody treatments
Long-acting antibody (LAAB) combinations mimic natural antibodies, to support the bodies own immune response. The STORMCHASER study is investigating whether an LAAB called AZD7442 (developed by AstraZeneca) can offer protection to people recently exposed to the virus, and prevent them developing infection. The world’s first participant to receive this treatment through the study was recruited in the UK through the NIHR.
The RECOVERY trial is also currently investigating an alternative monoclonal antibody combination called REGN-COV2 (developed by Regeneron).
The value of negative results
Not all clinical research studies result in effective treatments being identified. Some NIHR-supported studies have proven that certain drugs previously touted as potentially beneficial, have little or no benefit for COVID-19 patients.
After contracting a virus, blood plasma contains antibodies that may help fight infection. REMAP-CAP and RECOVERY were amongst the first studies in the world to investigate the use of convalescent plasma for hospitalised patients with COVID-19. However both RECOVERY and REMAP-CAP found no overall benefit of convalescent plasma as a treatment for both seriously and moderately ill hospitalised COVID-19 patients.
Convalescent plasma was once widely considered a therapeutic option with a high potential for treating Covid-19 - yet NIHR-supported research has shown plasma transfusion to be ineffective overall. While disappointing, data from these vital studies will allow clinicians the world over to focus treatment decisions on proven therapeutic options.
Prof Nick Lemoine, Medical Director, NIHR Clinical Research Network
RECOVERY was also one of the world’s first studies to show that the antimalarial medication, hydroxychloroquine, has no beneficial effect in patients hospitalised with COVID-19.
Despite negative findings, studies like these are vital to shaping clinical practice worldwide, enabling clinicians to focus on proven treatments. This is hugely beneficial, not only to advancing science around this new disease, but ultimately saving lives, while preventing health providers from wasting resources on ineffective treatments.