Will we know if the treatments are effective ... when the hospital beds are empty? "It's always like that during epidemics, we arrive every time too late," regrets Djillali Annane, the head of resuscitation at the Raymond-Poincaré hospital in Garches (Val-d'Oise). As the number of critically ill patients decreases, research into drugs for Covid-19 is far from complete.
On the doctors shelves, for the moment there is not much. However, with 45 clinical trials in France, white coats and politicians hoped to find the healing molecule. Did Emmanuel Macron himself not promise results on May 14? It was ten days ago, and still nothing on the horizon.
Discovery, already renamed "fiascovery"
Discovery, the big study that everyone was talking about, made "pschitt" to the point of being renamed by some pundits of "fiascovery" medicine. "There will probably be nothing. It is the mountain that risks giving birth to a mouse, ”warns infectiologist Eric Caumes. Over 3000 patients across Europe had to test four drugs with unpronounceable names, hydroxychloroquine, lopinavir and other remedies. But lo and behold, only France has played the game - and again, without reaching its planned 800 patients. Our neighbors are lagging behind. Some barely get started. Consequence: we missed the check mark.
“We encountered several regulatory and financial difficulties. Each country had to obtain its authorization. Here it took 48 hours, in Austria, five weeks! There have also been disagreements between scientists, for example on the doses to be administered, ”notes Yazdan Yazdanpanah, infectiologist at the Bichat hospital in Paris and head of the consortium of researchers who coordinates Discovery.
Worse, no molecule shows real effectiveness. "These are not miracle drugs, otherwise we would have seen it before. We must give hope, but not false hope, "recognizes the doctor, adding that the work will be carried out to the end.
An overwhelming study for hydroxychloroquine
Others go further, evoking a game lost in advance. "The Chinese had already tried everything and said it didn't work," tackles Professor Eric Caumes. "I was not going to give Kaletra (made from lopinavir in particular) or remesivir to my patients knowing that it was not relevant," says Djillani Annane. He opted for hydroxychloroquine, the star treatment advocated by Marseille professor Didier Raoult. "I have good experience with it, but that is not enough to draw conclusions from it. "
However, these conclusions arrive and it is the collapse. A study published this Friday, May 22 in the prestigious medical journal The Lancet and conducted on 96,000 people infected with the coronavirus alert: these tablets not only do not knock out the virus, but they increase the risk of death. “Hydroxychloroquine is almost completely buried. I wonder why it would be worthwhile to continue the 140 trials conducted around the world, ”says Professor Caumes.
Hope for severe forms
Does this mean giving up? No, there is hope. And in particular for the most serious cases, those for which the body gets carried away, over-reacts to the virus to the point of destroying itself. Among the drugs under study against this inner storm, there are corticosteroids, tocilizumab ... And a new one, called avdoralimab which must be tested on a hundred patients. "The goal is to block the inflammatory cascade and thus help the patient to get out of it," explains Eric Vivier, professor of immunology in Marseille (Bouches-du-Rhône), who is conducting the study.
Once the crisis is over, how can we work better together? For Djillali Annane, you have to pool your talents and resources. “We are not organized, disciplined and collective enough. Let's make a European research institute on infectious and emerging diseases. "
