June 25, 2003

 

Ribavirin to Rimantidine? The Need for Clinical Trials for SARS Rx

 

Given: There are no FDA-licensed drugs proven effective for SARS prophylaxis or treatment (Rx). Thus, clinical trial are needed ASAP.

 

 

I. FDA-licensed drugs for non-SARS indications (thus, “off-label” use for SARS):

 

1. Ribavirin: Not active in vitro. Given to patients (e.g. Hong Kong, Toronto)

2. Lamivudine: Given to patients in Hong Kong ( If chronic Hepatitis B+)

3. Lopinavir/ritonavir (“Kaletra”: an HIV protease inhibitor): Given to some  patients (e.g. Hong Kong)

4. Corticosteroids: Given to patients (e.g., Hong Kong, Toronto)

5. Rimantidine: Some activity in vitro. Not given to patients (yet).

6. Interferon beta: some activity in vitro. Not given to patients (yet).

7. Interferon alpha: some activity in vitro. Not given to patients (yet)

8. Others

 

 

II. NON-FDA-licensed (for any indication) drugs or immunotherapies:

 

1. SARS virus-specific immunoglobulin: Given to some patients (e.g., Hong Kong)

2. Cysteine protease inhibitors: Some activity in vitro. Not given to patients

3. SARS coronavirus peptides: Some activity in vitro. Not given to patients.

4. Glycyrrhizin: Some activity in vitro (Lancet 6/14/03). Not given to patients.

5. Others

 

 

 

Daniel R. Lucey, MD, MPH

Co-Chair, DC Hospital Association Infectious Disease/Infection Control Committee

Meeting Discussion on SARS June 25, 2003

Director, Center for Biologic Counterterrorism & Emerging Diseases

Washington Hospital Center, Washington, DC

Website: www.bepast.org for SARS updates, this synopsis, and weblinks to Rx