The success of vaccines has reduced the pool of people available for studies, among other factors
After two years of breakneck research, scientists have amassed a collection of therapies to treat people with COVID-19. But now, researchers fear that development of new treatments could falter as the clinical trials needed to test them become increasingly difficult.
Doctors treating people with COVID-19 can choose from roughly half a dozen types of therapy that have been recommended by the World Health Organization, or by national authorities such as the US Food and Drug Administration . Among them are steroids, synthetic antibodies and antiviral tablets. Some cut the risk of death for those already in hospital. Others lower the odds of having to be hospitalized at all.
At the beginning of the pandemic, health researcher Edward Mills at McMaster University in Hamilton, Canada, and his colleagues set up a trial in Brazil to learn whether existing drugs could prevent the most serious outcomes of COVID-19. When they launched the trial, called TOGETHER, in early 2020, the share of study participants who eventually died or had to be hospitalized was 16%. But the number dropped to 3–5% after vaccines became available.
But Hohmann says that, as effective treatments such as remdesivir became available, it became more and more difficult to recruit participants for subsequent trials. Many people feel safer sticking with the established regimen, which today includes both remdesivir and the steroid dexamethasone, than trying an experimental drug as well.
Statistical complexity As treatments have multiplied, so too has the complexity of the statistical calculations needed to determine whether a new drug is effective. As a result, researchers might need to recruit more trial participants, which takes more time.
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