Clinical trials for coronavirus have begun. First up: approved antivirals, malaria treatments and steroids

At least 31 clinical trials are under way to test therapeutic interventions for 2019-nCoV acute respiratory disease, according to ClinicalTrials.Gov and the Chinese Clinical Trial Register.

19 of the trials include a treatment arm testing an approved antiviral, including HIV drug Kaletra lopinavir/ritonavir from AbbVie Inc. (NYSE:ABBV) and Arbidol umifenovir, a flu therapy approved in China and Russia but not in the U.S.

Several trials are combining antivirals with corticosteroids; one is evaluating methylprednisolone alone.

Four trials are investigating antimalarial treatments. A Cell Research study from the Wuhan Institute of Virology found the antimalaria agent chloroquine blocked virus infection with an EC50 of 1.13 uM. Because chloroquine inhibits endosomal acidification, it could stop the release of viral DNA into the cytoplasm (see “Coronavirus Biology”).

The paper also found potent activity for the unapproved antiviral remdesivir from Gilead Sciences Inc. Remdesivir reduced 2019-nCoV infection of monkey kidney cells with an EC50 of 0.77 μM.

Remdesivir, which is being tested in two trials, has already almost completely cleared one U.S. patient's symptoms. Gilead has been ramping up manufacturing of the antiviral.

Separately, two Chinese institutions applied last month for a patent on the use of the antiviral to treat 2019-nCoV (see "O'Day on Remdesivir").

Five trials are evaluating cell-based therapies to treat 2019-nCoV, including mesenchymal stem cell transfusions.

Not included in the table are trials testing traditional Chinese medicines or interventions without a compound name.

Further analysis of the coronavirus crisis can be found at https://www.biocentury.com/coronavirus. The 2019-nCoV content is free to all who visit the site.