LAUSR

On 29 June, University of Oxford clinical scientists Martin Landray and Peter Horby changed how physicians around the world consider treating COVID-19—for the third time in little more than 3 weeks. The principal investigators of a U.K. megatrial called Recovery, which has been testing existing drugs as therapies for the new disease, they had just finished reviewing data from patients who had received a combination of lopinavir and ritonavir, two antivirals known to curb HIV, and others who had received only standard care. In a press release, they and their Recovery colleagues announced there had been no significant difference in the death rate between the two groups. Earlier in June, and again through press releases, Recovery delivered widely accepted verdicts on two other treatments. Large, randomized trials are the gold standard for testing a drug9s efficacy, but they have been scarce so far in this pandemic. In a sea of small, single institution studies, Recovery, with 12,000 patients and hundreds of participating hospitals, stands out—and offers lessons for the few other megatrials that have been slow off the mark.