A drug to reduce blood clots, widely prescribed to Covid-19 patients after discharge from hospital, does not lessen their chances of readmission or improve survival, according to groundbreaking research which is set to change treatment protocols around the world.
The results of the UK-wide trial, led by Addenbrooke’s Hospital and the University of Cambridge, were shared with the Financial Times. They found that prescribing the anticoagulant Apixaban did not help patients recovering from moderate and severe Covid and in a small number of cases caused serious harm.
Around 29.1 per cent of people given the drug ended up back in hospital or died, compared with 30.8 per cent receiving standard care.
The findings are the first to emerge from a pioneering study called HEAL-COVID — Helping to Alleviate the Long-term consequences of Covid-19 — led by Prof Charlotte Summers, an intensive care specialist at Addenbrooke’s in Cambridge.
Summers believes it is the only trial in the world examining treatments for patients who have recovered from Covid, about one in three of whom die or require readmission to hospital within a year. She said: “Having survived the ordeal of being hospitalised with Covid-19, far too many patients find themselves back in hospital, often developing longer-term complications as a result of the virus.”
Dr Mark Toshner, joint chief investigator for the study with Summers, said: “Up until now it’s been assumed that Apixaban helps patients recover after severe Covid-19 and that thinning their blood to prevent clots is beneficial.” The researchers’ hope was that “these results will stop this drug being needlessly prescribed to patients with Covid-19 and we can change medical practice”, he added.
The study, carried out in collaboration with Liverpool Clinical Trials Centre and Aparito, a health technology company, also showed no benefit from Apixaban in terms of the number of days patients remained alive and out of hospital 60 days after their initial discharge: for both forms of treatment the average was 59 days.
Of the 402 trial participants receiving the medicine, a small number had major bleeding that meant they had to stop the treatment. All therapies, Summers cautioned, had risks “and you don’t want to give people a risk for no benefit”.
The trial is funded by the National Institute for Health and Care Research (NIHR) and the Cambridge NIHR Biomedical Research Centre. So far more than 1,100 NHS patients hospitalised with Covid have taken part.
Evidence of the virus’s continuing effects had created “an urgent need for us to find treatments that prevent this significant burden of illness and improve the lives of so many still being affected by Covid”, Summers added.
The study will continue to test another drug called Atorvastatin, a widely used lipid lowering drug, or “statin”, that acts on other mechanisms of disease that are thought to be important in Covid.
Professor Nick Lemoine, NIHR Clinical Research Network Medical Director, said results such as those from the HEAL-COVID study “help to strengthen our knowledge of how patients can be treated following their stay in hospital and how recovery rates can be improved upon”.
Findings from clinical trials, “whether they identify new treatments or rule out methods of care, are vital and rigorous evidence when it comes to changing best medical practice”, he added.