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A recent study by NDM’s Mahidol Oxford Tropical Medicine Research Unit researchers highlighted that there was no difference in the rate of viral clearance between patients given Favipiravir and patients receiving no study drug.

Dr Will Schilling, co-Head of the PLATCOV study and Oxford DPhil Student, demonstrates swabbing to Lao colleagues at a PLATCOV site inspection visit in Vientiane, Lao PDR. © MORU/LOMWRU. Photo credits: Latsaniphone Soutthasavong.

After recruiting 240 low-risk adult patients with early symptomatic COVID-19 to the multicentre open-label, randomised, controlled, adaptive PLATCOV platform trial, the Mahidol Oxford Tropical Medicine Research Unit (MORU) researchers gave Favipiravir to 114 randomly selected patients and no study drug to 126 randomised patients. They found no difference in the rate of viral clearance between patients given Favipiravir and patients receiving no study drug. The researchers found that giving high oral doses of the anti-influenza drug Favipiravir to adults with early symptomatic COVID-19 treatment did not accelerate viral clearance. The study was published in BMC Infectious Diseases.

Professor Sir Nick White, Professor of Tropical Medicine, and co-Principal Investigator based at MORU, said: ‘This study reinforces the important principle that before an anti-infective drug is recommended for general use its activity needs to be evaluated in patients as well as in the laboratory. Favipiravir, an anti-influenza drug, has activity against the SARS-CoV-2 virus in the laboratory, and has been recommended for the treatment of COVID-19 in some countries – but our study showed that Favipiravir provides no benefit in treating early COVID-19 infection.’

The Mahidol-based University of Oxford-affiliated researchers developed a simple method of quickly assessing the antiviral activity of COVID drugs in people with mild infections based on frequent measurements of the amount of virus at the back of the mouth.

In 2021, funded by the Wellcome Trust (UK), they started PLATCOV – a series of studies to determine the efficacy of antiviral drugs that were being used to treat COVID-19 infections.

Dr William Schilling, Research Physician, DPhil student based at MORU in Bangkok and co-Principal Investigator of the study, said ‘Favipiravir was recommended for the treatment of uncomplicated COVID-19 in several countries including Japan, Russia, Saudi Arabia, Turkey, Hungary, Kenya and Thailand. The study underlines the need for clinical trial evidence to determine if there is really a benefit. In some cases, there were effective alternative treatments available. Belatedly developing this evidence on the effectiveness of drugs which were used in the COVID pandemic, and the optimal way to assess them, will, we hope, prove beneficial in the future.’

The PLATCOV testing method sets the stage for future rapid comparisons of antiviral drugs for COVID and other viral infections such as influenza.

Dr Podjanee Jittamala, Senior Research Physician in MORU’s Clinical Therapeutic Unit and author of the paper, said: ‘The PLATCOV platform is a simple, well tolerated method of comparing antiviral drugs in patients with mild infections. It provides critical information on antiviral activity. COVID-19 is still common – and large clinical trials are expensive and take time. We cannot be sure that COVID will not become serious again, so we need methods of comparing medicines rapidly to inform treatment guidelines.’

Read the full paper here: