With a stellar team, we did just that for eight different repurposed drugs being proposed as COVID-19 treatments. We set out to evaluate the quality and precision of real-world observational studies (RWS) versus randomised controlled trials (RCTs). Any answer we found would have profound impact on the scientific community’s ability to respond quickly and well to future pandemics. With 249 study results from a larger database that is accessible to any qualified researcher, we have some important results demonstrating the value of RCTs over RWS.

Our work suggests that RWS generally exaggerate the potential benefit of repurposed drugs. RWS are also more variable than RCTs. The differential could be explained in part (but not fully) by a few design choices. Looking at the time course of results reading out during the pandemic, larger RCTs are key in getting a clear answer as to the degree of efficacy we can expect from a treatment. So being able to deploy large RCTs faster is critical to a better response for any future health emergency. More insights can be found in our open access paper. 

This work represents a massive effort by Jaap Mandema, Nevine Zariffa, Hugh Montgomery OBE, Louis Dron, Shuai Fu, Estelle Russek-Cohen, Ena Bromley, Samer Mouksassi, Pharm.D., PhD, FCP, Amy LaLonde, Aaron Springford, Larry Tsai, Phil Ambery, Doug McNair, Nawab Qizilbash, MD DPhil(Oxon.) and Stuart Pocock. Thanks Steven E. Kern for your vision and steadfast support. Mary White was also instrumental.

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