The AustralaSian Covid-19 trial (ASCOT) which aims to discover which existing treatments are most effective in hospitalised patients has been expanded into India.

The first patients were recruited last week to the first two sites, Christian Medical College and Hospital Ludhiana in Punjab and Sterling Multispecialty Hospital in Pune, Maharashtra, George Institute for Global Health which has partnered with ASCOT to oversee the trial in India said on Monday.

vaccination

While ASCOT began as an Australian and New Zealand trial, expanding internationally to allow more widespread access to investigational treatments was crucial, according to ASCOT Principal Investigator, Associate Professor Steven Tong, a Royal Melbourne Hospital infectious diseases clinician and co-lead of clinical research at the Doherty Institute.

"A key principle of the trial is equity in terms of access to experimental treatments that could potentially have benefits for patients," Tong said.

"The ASCOT Management Team and Leadership Group recognised early in the course of the trial that in order for it to have generalisability, external validity and be adequately powered, it would need to be expanded to international sites."

Combination of treatments

The number of patients with Covid-19 in India remains significantly higher than in Australia and New Zealand.

While there are other ongoing clinical trials in India for Covid-19, the novel combinations of treatments included in ASCOT will provide greater opportunities to patients for accessing new treatments, said Bala Venkatesh, Professorial Fellow at the George Institute for Global Health.

One new treatment that's recently been added to ASCOT is nafamostat, which in laboratory experiments has shown to block SARS-COV-2 from entering human cells and be far more potent than remdesivir.

"Nafamostat is mainly used in Korea and Japan as a treatment for acute pancreatitis and some blood clotting conditions," explained Tong.

The ASCOT trial aims to generate results quickly. After the trial begins, results will be continually analysed, so that ineffective therapies can be stopped and new therapies can be evaluated as part of the trial.