Sep 28: Marc Bonten interviewed for new UMC Utrecht podcast series
Science journalist Jop de Vrieze interviewed Marc Bonten (as a pilot for a forthcoming UMC Utrecht podcast series) about COVID-19 and in particular the ongoing scientific studies at UMC Utrecht. They discuss – amongst others - the epidemiological aspects of COVID-19, how to prevent infection and clinical research (including prevention through vaccination and old/new treatment modalities).
Treatment of COVID-19
In 2014 the REMAP-CAP study was started in the context of pandemic preparedness. One goal of this study - which now runs in 256 hospitals on 4 continents - is to quickly and effectively test various medications against pneumonia. The different treatments are selected based on an estimate of how serious the disease is and what the possible causes are. REMAP-CAP is a so-called adaptive platform trial (REMAP stands for Randomized, Embedded, Multifactorial, Adaptive Platform), a flexible clinical trial that allows for testing multiple medications at the same time.
Bonten says about the results: “In REMAP-CAP we investigate the effects of antiviral drugs, plasma therapy, anticoagulants, and immune modulators. Recently, we were able to confirm in this trial that administration of corticosteroids to patients with COVID-19 that end up in the ICU increases the chance of survival. What we do not yet know, for example, is the optimal dose of anticoagulant in these patients. We also try to unravel this in REMAP-CAP. ”
Prevention of COVID-19
One of the first attempts to prevent COVID-19 is the use of the so-called BCG vaccine (originally developed against tuberculosis). The BCG vaccine appears to give a temporary boost to part of the immune system, and it is therefore expected that it also has a preventive effect against (serious consequences of) COVID-19. In April, two placebo-controlled studies with the vaccine were started in the Netherlands (coordinated by UMC Utrecht and Radboudumc) in healthcare workers (prevention of absenteeism) and healthy elderly (prevention of COVID-19).
Marc Bonten on the BCG vaccine studies: “These studies are currently in their follow up phase, where we look at whether there is less disease in the recipients of the vaccine as compared to people who received a placebo. Our studies have now been copied abroad, where they are now also running. UMC Utrecht clinical investigator Henri van Werkhoven has now agreed with the researchers of these foreign studies that the data will be analyzed together with ours in a meta-analysis, so that we have tangible results as soon as possible. In addition, a large and more detailed international study of the BCG vaccine in healthcare providers has recently started (sponsored by the Bill & Melinda Gates Foundation), in which we also participate. Finally, this month we started a large Dutch study in 22 hospitals in which we are investigating the BCG vaccine in the vulnerable elderly (elderly people who have recently been admitted and/or who have conditions for which they are under treatment at a hospital).
Finally, UMC Utrecht is participating in an international Phase 2 study with one of the COVID-19 vaccines (the one under development by Janssen Vaccines in Leiden). More than 500 volunteers are being investigated to evaluate whether the vaccine is safe, well tolerated and whether it elicits the correct immune response. Marc Bonten says: “This study started this month, and the efficacy and safety of this vaccine are now being investigated in a large Phase 3 study as well (which is not running in the Netherlands, by the way). Finally, the safety of all COVID-19 vaccines is extensively monitored and compared in a large European study coordinated by Mirjam Sturkenboom of UMC Utrecht.”
The audio of the full interview with Marc Bonten (in Dutch language) can be found by clicking here.