The Australian research landscape
Australian researchers, often working with global partners, are testing repurposed drugs as well as
developing new therapies. Below is a snapshot of some Australian research that relates to the strategies
described above.
• REMAP-CAP* is an international trial for COVID-19 patients in intensive care with severe pneumonia.
Australia currently has more than 50 intensive care units participating in this trial.44 The trial is
testing several different therapies, including lopinavir-ritonavir and hydroxychloroquine, alone or in
combination; as well as an immunomodulator called Interferon-beta-1a and an anti-cytokine agent,
Kineret (Anakinra, an IL-1 inhibitor).
Tocilizumab and sarilumab have been submitted for approval as
additions to the study trial options. Proposals to add anticoagulation, vitamin C, and convalescent
plasma to the trial have been submitted or approved in other countries and will be submitted in
Australia.
The trial uses an adaptive design to evaluate a number of therapeutic options
simultaneously and efficiently, meaning that the trial can adapt to increase the likelihood that
patients will receive the therapeutic that is most likely to be effective for them. Where specified, the
trial can also identify the therapeutic effect of combination therapy.
It is important to note that
* Randomised, Embedded, Multi-factorial, Adaptive Platform Trial for Community-Acquired Pneumonia (REMAP-CAP)
Rapid Research Information Forum
The most promising therapeutics for COVID-19
8
REMAP-CAP only enrols patients in the advanced stage of disease, where antivirals may have limited
benefit.
• The ASCOT† study, led by the Doherty Institute, is investigating hydroxychloroquine and lopinavirritonavir for COVID-19.45 The ASCOT trial will enrol people with mild to moderate disease who are in
hospital, but will not include patients in intensive care.
• The CoPEP‡ study, led by Monash University, is exploring the use of hydroxychloroquine and other
antivirals (e.g., interferon, which stimulates the immune system) for post-exposure prophylaxis in
high-risk contacts using an adaptive randomised trial design, performed at sites in Australia and New
Zealand.
• The COVID-Shield study, led by the Walter and Eliza Hall Institute, is investigating
hydroxychloroquine for pre-exposure prophylaxis for healthcare workers in Australia.
• Cell culture studies on ivermectin were undertaken by investigators from Monash University and the
Doherty Institute. Further work is being carried out in Australia to determine the efficacy and safety
of ivermectin in humans.
24
• The design, screening and development of siRNAs that target SARS-CoV-2 is being undertaken at the
Kirby Institute, the University of Melbourne, RMIT and the Walter and Eliza Hall Institute.
• Planning and pre-clinical work is underway in Australia on the development of hyperimmune
globulin – driven by CSL and the Australian Red Cross Blood Service, in association with Monash
University, the Doherty Institute, the Kirby Institute and Westmead Hospital. Trials will begin later in
2020.
• Australian researchers are also actively working to identify and develop monoclonal antibodies and
broadly neutralising antibodies for COVID-19, including at the Kirby Institute, Garvan Institute,
Doherty Institute and Burnet Institute.
• CSL has three anti-cytokine antibody products in early clinical trials, which could potentially be
repurposed. Rigorous testing would be needed, but if successful the manufacturing process is well
understood and is available at CSL facilities in Australia.
Pharmaust may utilise this study platform ? Being Part of the Forum would assist with access to Living Cov 19 Patients , especially as PAA have a Repurposed Drug with an extensive Safety History and Previous Human Trial Data.
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