5．Confronting COVID-19： Current Issues of SARS-CoV-2 Therapeutic Drug/Vaccine Development / 薬剤疫学

ABSTRACT

The development of therapeutic agents is important for controlling emerging infectious diseases. However, looking back into our experiences for the last three decades, there were no effective treatments at the beginning of the pandemics. Generally, the first step to develop therapeutic agents for emerging infectious diseases is to search for already existing agents that might have therapeutic effects, and so did with COVID-19. Many candidates have been examined with hopes of success for the past year. Up to now, only two agents, remdesivir and dexamethasone, which were anti-viral and anti-inflammatory agents, respectively, were approved as therapeutic agents. The two drugs are approved based on the results of clinical trials performed overseas and not in Japan. Though many other candidate drugs have been proposed and clinical trials have been carried out in Japan, few studies have reached clear conclusions. The reasons for these ineffective study-progress are not clear, but it appears that high hurdles may exist for doctors to participate in RCTs, probably due to the lack of human resources that can be invested in implementing RCTs. Based on the lessons learned from this pandemic, to proceed RTCs effectively, a new organization with the role of a command tower to manage and support RCTs is eagerly awaited.