The spread of the SARS-CoV-2 coronavirus, unknown three months ago, has challenged scientists around the world. With 440 clinical trials identified this Monday, April 13, research on an emerging pathogen has never been faster. This proliferation is geared towards a single goal: to find as quickly as possible an effective treatment against Covid-19, this new disease against which there is no vaccine or cure.
France does not demerit either. She is even the European champion and third worldwide, behind the United States and China, which have launched 80 and 79 studies respectively, according to ClinicalTrials, the benchmark site that records clinical trials worldwide. With 45 tries, it is ahead of Italy (30), Germany (17) and even Spain (16). The United Kingdom, which has more than 10,000 Covid-19 deaths, has 15 studies. Unsurprisingly, the United States, the world leader in scientific research, is the country to have undertaken the most clinical trials related to the new coronavirus.
The Hexagon on the first place of the podium in Europe? Nothing very surprising when looking at the barometers of the French Association for Clinical Research under contract (AFCROs). For the past three years, France has already been the European leader in the number of clinical trials referenced.
However, "when we are only interested in private actors, France is in fourth position, behind Germany, the United Kingdom and Spain", details the Parisian doctor Denis Comet, president of AFCROs. This delay in the search for industrial initiative is therefore compensated by the public sector, which propels the country in first position at European level.
This place at the top of the podium should be put into perspective, estimates Thomas Borel, scientific director of Leem, the professional organization of pharmaceutical companies operating in France. “In its annual barometer, AFCROs does not only take into account intervention research ( Editor's note: which aims to develop a drug ). It also integrates observational research ( once the marketing authorization has been granted, the researchers observe the results of the drug in the daily lives of patients ). "
Globally recognized teams
Of the 45 clinical trials related to the coronavirus in France identified by ClinicalTrials, 20 are of the intervention type. The highest number recorded in a European country. Italy has 17, Spain 13 and Germany 12. "As public research is very active and prepared in France, it is not surprising that the researchers could react quickly", judge Denis Comet. "In the field of infectious diseases, for example, French teams are recognized worldwide", abounds Thomas Borel, referring to "the Pasteurian tradition".
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Another element that can explain the important place of France in the quest for treatment against the Covid-19 disease: "Companies extremely involved in research are located on French territory," notes the scientific director of Leem. Their own medicines are sometimes at the heart of clinical trials. ”
Above all, the Ministry of Health and the Medicines Agency (ANSM) have enabled the acceleration of research projects. "With the Covid-19, we went from an average of 60 days to obtain authorization for a clinical trial to just a few days," notes Thomas Borel. “They are urgently studying the files. But, of course, all the necessary and reassuring steps, such as research security and its merits, are respected, ”says Denis Comet.
Finally, the patient recruitment process here is considerably accelerated since, unfortunately, France is one of the countries with the most Covid-19 patients.
Varied studies
The expectations for these clinical studies are very high, especially since some of the treatments tested are already available in other indications. This is the case of the famous chloroquine, and its derivative hydroxychloroquine. This antimalarial drug was popularized by the media professor Didier Raoult. Studies of the latter are not listed by ClinicalTrials, but at least four other clinical trials related to chloroquine are launched in the country.
The European project Discovery, coordinated by the French public body Inserm, is thus studying the effects of hydroxychloroquine, but also of three other potential treatments: the antiviral remdesivir, the combination of two anti-retroviral drugs lopinavir / ritonavir and these two latest combined with interferon beta.
To counter the "inflammatory storm" observed in severe forms of the disease, researchers are also testing in France the monoclonal antibodies sarilumab (Sanofi and Regeneron) and tocilizumab (Roche), drugs against rheumatoid arthritis blocking the receptor of a immune system protein.
"Its population will be able to benefit from treatment first"
Called Coviplasm, a clinical trial which consists of transfusing blood plasma from people recovered from Covid-19 to patients in the acute phase of the disease started on Tuesday April 7 in France. Two hundred recovered people are removed and 60 patients included in the clinical trial, said the AP-HP, Inserm and the French Blood Establishment (EFS).
The Assistance Publique-Hôpitaux de Paris is also behind the Stroma-Cov2 trial to treat intubated patients. It consists of three administrations of so-called “mesenchymal stromal” cells of the umbilical cord, repeated every 48 hours. These cells in particular have anti-inflammatory properties.
If one of these numerous clinical trials proves conclusive, "the medical profession which will have participated in the research will have a practical advance," notes doctor Denis Comet. Its population will be able to benefit from treatment first ”.