An international team of scientists has created a plan for an accelerated pipeline for developing drug cocktails to battle the COVID-19 pandemic.

The “proactive drug development strategy” could also offer a first line of defense against future pandemics, according to researchers from the University of Virginia School of Medicine (Charlottesville, VA, USA) who are joined by Immunology and Cancer Biology, University of Washington, Fred Hutchinson Cancer Research Center; University of Maryland; and MRI Global, as well as collaborators in Estonia, Finland and Norway.

The pipeline could speed new and better treatments that the newly diagnosed and recently exposed could take at home to prevent serious illness. The approach would allow scientists to be ready with an arsenal of drugs that could be quickly moved into clinical trials when a dangerous new infection appears, whether a coronavirus or another pathogen. The goal: Make effective treatments available in weeks, not months or years.

The scientists believe that prioritizing the development of drug cocktails – treatments that combine two or more medicines – would reduce the burden on health care systems and help prevent disease spread by limiting a virus’ ability to adapt to its hosts. This type of combination approach is already the norm for treating viruses such as HIV. To demonstrate the potential of computer modeling for this purpose, the scientists have developed a model to assess the potential clinical effectiveness of drug pairs for treating COVID-19. Pairing drugs, the researchers say, could make for treatments that are more effective than individual drugs alone. Identifying drugs with this type of “synergy,” they say, could potentially turn two medicines of only modest benefit into a potent treatment. The scientists emphasize that better treatments for COVID-19 will not supplant the need for vaccination and are a complement to existing strategies. But they say their strategy could lead to better outcomes for patients who contract COVID-19 – or the next dangerous virus waiting in the wings.

“We need to proactively develop drug cocktails against virus families as a whole – for example, all coronaviruses – to be ready on day one if a new virus or variant emerges. The cocktail should be low-cost, easy to transport and distribute, and easy to self-administer – therefore available to people across the globe,” said researcher Judith M. White, a professor emeritus at the University of Virginia School of Medicine. “We hope that this concept of ‘smart drug cocktails’ – smart because of the choice of drugs for testing and computer modeling of their effectiveness in humans – will be the basis for a robust, coordinated effort against coronaviruses and other pathogenic viruses, such as Zika and Lassa fever viruses, just to name a few.” 

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