The FDA's new app for frontline doctors could help discover Covid-19 treatments faster

A new app developed by the FDA enables doctors to spend a few minutes submitting case reports about how they've treated unique patients.

(CNN)In the trenches of the fight against coronavirus, Dr. Raghav Tirupathi often has little time to think and no textbook to follow while treating patients with Covid-19.

That's why the infectious disease specialist in Chambersburg, Pennsylvania, finds himself increasingly turning for guidance to Cure ID, an app developed by the US Food and Drug Administration enabling doctors to consult with each other across hospitals, academic disciplines and international borders.
He uses many of the established treatments -- the antiviral drug remdesivir, the corticosteroid dexamethasone and convalescent plasma. But in the minutiae of a patient's given situation and with treatment guidelines regularly updated, the Cure ID app is vital for him to compare notes with other doctors about which drugs to administer, and in what order.
"Things happen quickly and we can't afford to think about phases," said Tirupathi, who practices in a rural community hospital. "They reassure me that I'm not the only one doing it. We use Cure to justify what we are doing in our institution."
    He's one of thousands of doctors sharing information via an app the US government agency hopes will spur new cures for hundreds of difficult-to-treat diseases.

    App origins

    The app wasn't designed for a pandemic, but it's just in time for one.
    Launched by the FDA and the National Center for Advancing Translational Sciences at the National Institutes of Health in December 2019, the app has enabled doctors to write and submit anonymized case reports about their patients in just minutes for 325 distinct diseases.
    After downloading it from Apple's App Store or Google Play, users confirm they are licensed health professionals. Then they can view case reports organized by disease, create their own reports and engage with the medical community via the app's community forum.
    Cure ID was originally developed to aid in repurposing old drugs for new uses, according to Heather Stone, the app project lead and a health science policy analyst at the FDA.
    Drug repurposing is a shortcut around the process to bring a brand-new drug to market, which can take 10 years and an estimated $2.6 billion, according to the Pharmaceutical Research and Manufacturers of America, a trade group.
    Cure ID was designed to cut down that time and cost, particularly to focus on rare diseases that perplex doctors and don't always get much attention from major drug companies.
    After the pandemic hit, the FDA and NIH created a new section of the app so doctors could input data solely around their Covid-19 findings.
    "Time is of the essence to find new therapies for Covid," Stone said. "Cures may already be sitting on a pharmaceutical shelf somewhere as we speak."
    With more than 864,000 Covid-19 deaths globally over the last eight months, the standard process of writing up a case study for publication in a medical journal could leave thousands of lives hanging in the balance as potentially lifesaving information finds its way to doctors who can use it. (To be sure, journals are speeding up publication in the face of the pandemic.)
    And with many doctors cloistered in academic disciplines such as infectious disease or pulmonology, the FDA and NIH believe the app can break down silos and address the problem of health providers missing new insights discovered by researchers in other disciplines.
    "This provides a wider audience," Stone said.
    The app is organized by disease and allows doctors to discuss how and why a drug may have worked in a given condition.

    The potential to crack hard-to-treat cases

    Stone joined FDA in 2013 after completing a master's degree in public health that included fieldwork at a remote hospital nestled in the foothills of the Himalayas. While there, she met a man with a multidrug-resistant tuberculosis, for whom different 12 drugs had failed.
    After searching the academic literature for hours, she and a doctor found a drug combination that had saved the life of a young girl in a similar situation. Those drugs had been approved decades earlier, although not for tuberculosis.
    Stone and the doctor believed that the combo would work on the elderly man as well, but by then they were too late to save his life. Stone spoke to dozens of other patients who had been treated with the same drugs and recovered. In her five years of pioneering the Cure ID app, those patients have kept her motivated.