Hamilton researchers change course on COVID-19 treatment
New focus on testing blood thinners and anti-inflammatory drugs
Hamilton researchers studying potential COVID-19 treatments have completely changed course and are now testing anti-inflammatory drugs and blood thinners to avoid deadly complications of the virus. “When we designed this study, we knew that we would have to be able to pivot based on emerging evidence,” said Dr. Richard Whitlock, Hamilton cardiac surgeon and researcher. “This disease has been so fast moving that we need to be agile.”
Originally, the much-publicized malaria medication hydroxychloroquine was being tested along with antibiotic azithromycin in the “Anti-Coronavirus Therapies to Prevent Progression of COVID-19 Trial.”
But the University of Oxford came out with findings from its “RECOVERY” study in June that found no clinical benefit of hydroxychloroquine and raised concerns about the safety of the treatment in August.
“It was a very well done trial and it was a robust answer,” said Whitlock. “We were satisfied that they had answered that question.”
The Hamilton researchers turned instead to the body’s inflammatory response to the virus as well as the danger of blood clots that can cause strokes, heart attacks and limb amputations in COVID-19 patients. Both can have catastrophic results even in the young.
“It really stands out in the younger patients,” said Whitlock. “They tend to mount a pretty intense inflammatory response. And it’s always this surprise with younger patients being found with strokes who are in their 30s and 40s with the disease.”
Hamilton actor Nick Cordero died July 5 at the age of 41 after spending 13 weeks in intensive care with COVID-19. During that time, his heart stopped, blood clots caused his right leg to be amputated just above the knee, he suffered a series of small strokes, a temporary pacemaker had to be implanted and he developed holes in his lungs.
“The complications that he faced … is what we hope to avoid,” said Whitlock.
He adds these issues are even more prominent in seniors who get COVID. COVID-19 patients from Hamilton and other parts of Ontario may now be given antiinflammatory medication colchicine or blood thinners aspirin and rivaroxaban as part of the trial being led by the Population Health Research Institute (PHRI) affiliated with McMaster University and Hamilton Health Sciences.
The trial aims to recruit at least 4,000 patients — 2,500 recovering at home and 1,500 in hospital — from 11 countries.
Finding Canadian patients has been a challenge during the pandemic, putting researchers here behind other countries.
“Thankfully in Canada, we haven’t seen the massive waves of this disease that some of the other countries have seen,” said Whitlock.
Hamilton’s study will be able to boost its numbers by eventually merging its data sets with a separate study on colchicine being run in Argentina.
“We need to generate evidence quickly,” said Whitlock. “We’ll basically take the data from both these trials that are running in parallel and merge them so we have even more robust data and more robust answers.”
One of the reasons the researchers chose to look at blood thinners when they overhauled the trial is because Hamilton is known internationally for its work on blood clots.
“We have a vast experience in terms of anti-thrombotic therapies,” said Whitlock. “It was a natural fit for us to move into that realm.”
Whitlock says the fact PHRI has had to change the trial twice shows the value of doing rapid COVID research. They also looked at an antiviral interferon before dropping it because of the results of other studies.
“Never have I been involved in something that switches so fast,” he said.
“Staying on top of it is a challenge in itself.”