CTAG: Antiviral Agents

Download the Position Statement

(v4.0; 10 July 2020)

Key messages

  • Remdesivir is the only antiviral medicine approved for use in the treatment of COVID-19, receiving a conditional marketing authorisation on 3rd July 2020
  • DHSC and the devolved nations have produced an interim clinical commissioning policy and MHRA has issued an updated alert for the UK on use of remdesivir
  • Hospitals managing COVID-19 cases should make every effort to enrol COVID-19 patients in national priority clinical trials
  • Advice on the appropriate use of dexamethasone for COVID-19 is available at https://www.ctag-support.org.uk/immunomodulators
  • Suspected side effects to medicines used in coronavirus treatment should be reported via the Yellow Card COVID-19 reporting site: https://coronavirus-yellowcard.mhra.gov.uk/

Provenance

CTAG acts as a formal advisory group to the Royal College of Physicians and this position statement is endorsed by:

The CTAG Antivirals subgroup originally involved Infectious Diseases and Virology specialists from the High Consequence Infectious Diseases (HCID) Network, and subsequently expanded to include multidisciplinary representation from non-HCID NHS Providers.


Archives

Date publishedVersionAmendment
23 March 20201.0 Download PDFNew document
23 Mar 20201.1 Download PDFUpdated Gilead remdesivir Compassionate Use Programme eligibility criteria
27 March 20201.2 Download PDFAdded NHS England and NHS Improvement speciality guide for patient management. Added MHRA advice on chloroquine and hydroxychloroquine. Added hydroxychloroquine arm of RECOVERY study; added link to NIHR website.
01 April 20202.0 Download PDFUpdated evidence summaries in Appendix 1 (new trials for lopinavir/ritonavir and chloroquine). Merged ‘Position statement’ and ‘Decision Support Tool’ into a single document. Updated Section 3 with new trials. Updated Figure 1 with relationship between RECOVERY and PRINCIPLE/REMAP-CAP.
07 April 20202.1 Download PDFUpdated title to reflect updated scope (antiviral use in hospitals). Updated Section 2, 3 and Figure 1 with new trials and trial status. Included reference to CMO letter. Reformatting throughout. Added BIA and UKCPA-PIN logos (with permission).
08 April 20202.2 Download PDFUpdated membership & provenance. Corrected typo (2.5).
18 April 20202.3 Download PDFUpdated arms of RECOVERY study. Provided additional information for Gilead remdesivir Compassionate Use Programme. Updated references and web links. Updated evidence summaries in Appendix 1. Added azithromycin and inhaled interferon tables to Appendix 1.
01 May 20202.4Download PDFAddition of ‘Key messages’ and ‘Abbreviations’. Emphasised importance of avoiding off-label use of investigational antivirals. Added reference to ‘CTAG: Position Statement on the use of investigational immunomodulatory agents for COVID-19 in adults’. Format change to clinical trials tables. Change SNG016 and COPCOV from ‘proposed’ to ‘active’. Added GenOMICC study. Updated evidence summaries in Appendix 1 (remdesivir; nebulised interferon; added EMA statement for chloroquine/hydroxychloroquine).
22 May 20202.5 Download PDFIncluded reference to CMO letter and COVID-19 Yellow Card reporting. Updated
evidence summaries in Appendix 1 (interferon). Updated support for patients
diagnosed with COVID-19 whilst receiving investigative prophylactic treatment.
Removed reference to GenOMICC as out of scope. Updated RECOVERY eligibility
criteria to include paediatrics. Changed COPCOV from chloroquine to
hydroxychloroquine. Changed CROWN CORONATION from hydroxychloroquine to
chloroquine. Removed DisCoVeRy from Table 2.
06 June 20203.0Download PDFIncluded unlicensed remdesivir EAMS scheme and NHS implementation plan for that scheme; updated Section 2 accordingly and added a new monograph (Section 5). Moved studies ACTT-1, 5773, 5774 and SNG016 into a new ‘Closed to recruitment’ table. Updated evidence summaries in Appendix 1 (remdesivir; chloroquine/hydroxychloroquine).
12 June 20203.1Download PDFUpdated NHS implementation plan for EAMS. Updated evidence summaries in Appendix 1 (remdesivir; chloroquine/hydroxychloroquine).
29 June 20203.2 Download PDFMade reference to RECOVERY dexamethasone results. Added CTAG advice on the use of remdesivir. Updated arms of PRICIPLE study. Updated evidence summaries in Appendix 1 (systemic interferon; convalescent plasma).
03 July 20203.3Download PDFMoved ACCORD-2 to ‘Active studies’ table. Added discontinued arms of RECOVERY to ‘Closed to recruitment’ table. Updated evidence summaries in Appendix 1 (lopinavir/ritonavir).