The various experiences regarding the failure of the drugs tested in the fight against COVID-19 have clearly shown that there is at least a need to question the obligation to apply classic preclinical development strategies that require models of efficacy. cells and animals are tested before proceeding to clinical trials. Most animals are not susceptible to infection with SARS-CoV-2, which has led to experiments with unilateral replication of the virus in cells and the use of animal models that have little in common with the complex pathogenesis of COVID-19 in humans. Therefore, non-clinical development strategies were designed to meet regulatory requirements, but they did not really reflect the clinical situation. This has led to the search for effective agents in many cases misguided. As proof of this claim, we now collect the results of these required preclinical experiments and compare them with the results of clinical trials.
Two clear conclusions that can be drawn from the experience to date: benefit to patients under randomized blinded conditions. Our hypothesis is that the complex COVID-19 situation may benefit from multimodal drugs. Here, the molecular class of aptamers could be a solution.