Page 7 - Palliative Care, Trials and COVID-19 Tribulations: First-hand experience shared by the experts at ground zero

“Solidarity Trial - challenges and success” by Dr.

Chow Ting Soo, Penang General Hospital

Thank you, Dato’ Dr. Goh. I am going to share my slides and like Dato’ Goh has already
mentioned, this is a very special and unique trial that Malaysia is proud to be one of the
countries that are involved in it. I am going to share with you our experiences, the success
and challenges, that we met during this whole one year of clinical trial experience.

Introduction

As an introduction, Solidarity Trial is an international clinical trial designed and is led by
WHO (World Health Organization) and their partners. The objective is to identify a quick and
fast way to an effective treatment for COVID-19. You know that this COVID-19 pandemic
started in January of last year, up until today, there is not even one single agent identified
which can effectively treat COVID-19, as far as we are concerned right now.

This is one of the largest international randomized trials for COVID-19 treatment, and it
enrolled almost 12,000 patients. Out of 500 hospitals signed up, there were about 300 active
hospital sites involved in the trial, in over 30 countries.

What is Solidarity Trial?

This is a multi-centre, open-label and randomized trial. It evaluated four medications, which
were hoped to treat COVID-19 at that time including (i) Hydroxychloroquine; (ii)
Lopinavir/Ritonavir (the brand name Kaletra); (iii) Interferon and; (iv) Remdesivir, versus
standard of care.

So, we identified the patients, and they were randomized to receive either
Hydroxychloroquine, Kaletra (Lopinavir/Ritonavir), versus Lopinavir/Ritonavir Interferon,
and later Interferon only, or Remdesivir.

This trial looked at three important outcomes in COVID-19 patients, where the majority of
primary outcomes were (i) mortality in 28 days; (ii) the need for assisted ventilation and; (iii)
duration of the hospital stay.