France's leading role in search for Covid-19 cure

29 April 2020
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France has around 50 trials under way into possible Covid-19 treatments – more than any other EU country.

It has taken a lead in particular in the European Discovery programme, a major study involving 3,200 hospital patients in eight countries, including 800 in France. It is testing four existing medicines to see if they are effective.

The first results were expected to come out in late April – early May.

High-profile Professor Didier Raoult (right), an infectious diseases specialist from Marseille and a member of the government’s Covid-19 scientific advisory council, has championed the use of hydroxychloroquine, a variant of the malaria drug chloroquine.

People have been queuing at Marseille’s IHU Méditérranée Infection hospital for testing at his clinic, where the treatment is combined with the antibiotic azithromycin.

Prof Raoult went public with promising results in early unofficial trials.

Soon after, the government issued official advice that the drug may be used but restricted to hospital patients at an advanced stage of the virus.

President Macron has called him a “great scientist”, though he has stepped down from active involvement in the scientific council. Prof Raoult and his Marseille colleagues have been making extensive use of the drug, including at early stages, and claim rapid and effective recovery and a marked decrease in the time that people remain contagious.

They said in a statement that their action was in line with their Hippocratic oath to save lives.

Prof Raoult said in a recent YouTube update that they were “very happy” with the progress of treatment: 76,768 tests have been carried out on 32,083 patients, of whom 4,296 tested positive. He said that among those given the treatment there was a death rate of 0.4%, compared to an average rate across the world of over 6%.

“We have a rate which is one of the most, or the most, spectacular in the world,” he said, adding that the epidemic is now “disappearing” in the Marseille area, with around 60-80 new patients a day, compared to 368 at the peak.

Hydroxychloroquine is also one of the drugs being tested in the Discovery project, started in France with World Health Organisation backing on March 22. Florence Ader, infectious diseases expert at the Croix-Rousse hospital in Lyon, is coordinating the tests. However, it is not being used with azithromycin.

The other drugs are remdesivir, lopinavir and ritonavir, chosen after analysis of data on similar diseases including SARS and MERS, as well as early Covid-19 data from China.

French trials started in Paris, Lille, Nantes, Strasbourg and Lyon but other centres are progressively joining in. The UK is among countries taking part.The media buzz around the Marseille results led to a petition, led by former health minister Philippe Douste-Blazy and infectious diseases specialist Prof Christian Perronne, which has more than 560,000 signatures.

“Let’s waste no more time” (tinyurl.com/y7o5ra7d) calls for the drug to be available in all hospital pharmacies for patients showing any symptoms.

Health Minister Olivier Véran told website Brut that it was not up to Mr Douste-Blazy to “dictate” to him and he must be prudent. “I’m not taking a bet on French people’s health,” he said. 

One Discovery trial researcher also expressed irritation at Prof Raoult’s media exposure, saying patients now want only chloroquine and some are refusing to take part in trials in case they are given a different, or no, drug.

Some experts warn that chloroquine can have serious side-effects and risks, especially if patients have pre-existing conditions. These can include risks of hypoglycaemia for diabetics, blood issues such as anaemia, epilepsy, or visual impairment. It can also disturb the heart rhythm, according to the Ameri­can Heart Association, which said it can have serious effects for those with cardio-vascular problems – including higher risk of sudden death.

Possible dangerous interactions with other drugs for chronic illnesses are also cited as an issue.

Read more: French tests on Covid drug offer hope for severe cases

The head of Nice’s Pasteur hospital told Nice-Matin they halted its use for Covid-19 patients after “we discovered major risks of a very serious accident for a patient” at the start of trials of using it. The concerns were raised by checking ECG heart-rate results.

Around France several other avenues are being explored.

The Institut Pasteur in Paris will start trials on a vaccine for Covid-19 in July, though vaccination department head Dr Frédéric Tangy said that nothing will be available for at least a year.

“We will go as quickly as possible, but normally it takes at leasteight years to make a vaccine against a virus from scratch,” he said. 

The head of the government’s Covid-19 scientific council recently told the National Assembly that a vaccine that gives “incomplete protection” could be possible around the start of next year.

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