Inflammation Levels ‘Fell Like a Rock’
The Times of Israel reports $1.50-a-day lipid-lowering drug helps COVID patients in small Israeli trial.
A $1.50-a-day generic drug appears to have strong COVID-fighting ability, Israeli researchers say, after inflammation levels “fell like a rock” among coronavirus patients in a small clinical trial.
A research team from Hebrew University of Jerusalem proposed early in the pandemic that fenofibrate, a generic fat-lowering medication and one of America’s most prescribed medicines, could help COVID-19 patients.
It saw the drug effectively fight the coronavirus in-vitro a year ago, and has conducted data studies since. Now, the team has given the drug to 15 serious COVID-19 patients at Barzilai Medical Center in Ashkelon. All were receiving oxygen, yet all were discharged during the course of the 10-day trial.
The comparison data suggested that 80% to 90% of patients would experience a cytokine storm, the immune overreaction which often causes COVID deterioration. None of the 15 patients in the new study had an observable cytokine storm.
The medicine [Fenofibrate], which is sold under a number of brand names, is America’s 73rd most prescribed drug. It is designed to reduce lipids known as triglycerides, the most common type of fat.
The trial was conducted before the Delta variant arrived in Israel, but Nahmias voiced confidence that the drug would work on different variants.
What About Hydroxychloroquine?
Also consider Penn Study Uncovers Possible COVID-19 Drugs — Including Several That Are Already FDA-Approved.
The team, whose findings were published in Cell Reports, screened thousands of existing drugs and drug-like molecules for their ability to inhibit the replication of the COVID-19-causing coronavirus, SARS-CoV-2. In contrast to many prior studies, the screens tested the molecules for anti-coronaviral activity in a variety of cell types, including human airway-lining cells that are similar to the ones principally affected in COVID-19.
Of the nine drugs found to reduce SARS-CoV-2 replication in respiratory cells, three already have FDA approval: the transplant-rejection drug cyclosporine, the cancer drug dacomitinib, and the antibiotic salinomycin. These could be rapidly tested in human volunteers and COVID-19 patients.
For their screening project, Cherry and colleagues assembled a library of 3,059 compounds, including about 1,000 FDA-approved drugs and more than 2,000 drug-like molecules that have shown activity against defined biological targets. They then tested all of these for their ability to significantly inhibit SARS-CoV-2 replication in infected cells, without causing much toxicity.
Since SARS-CoV-2 is mainly a respiratory virus and is thought to initiate infections via airway-lining cells, the researchers sought a respiratory cell type that they could infect experimentally with the virus. They eventually identified a suitable cell line, Calu-3, that is derived from human airway-lining cells. They used these respiratory-derived cells to test the antiviral compounds identified through the human liver cell screen, and found that only nine had activity in the new cells.
By identifying different sets of drugs that work in different cell types, the researchers also shed light on the mechanisms SARS-CoV-2 uses to gain entry to cells. The findings suggest that in kidney and liver cells, the virus uses a mechanism that can be disrupted, for example, by hydroxychloroquine; yet the virus appears to use a different mechanism in respiratory cells, thus explaining hydroxychloroquine’s lack of success in those cells — and in COVID-19 clinical trials.
That last paragraph likely explains conflicting reports on the success or lack thereof of hydroxychloroquine.
UK Study On Fenofibrate
Clinical Trials Arena says Study Finds Fenofibrate’s Ability to Reduce Covid-19 Infection.
A research team led by the University of Birmingham and Keele University in the UK has found that a licensed oral drug, fenofibrate, and its active form, fenofibric acid, can substantially reduce SARS-CoV-2 infection in human cells in the laboratory.
Approved in various countries, fenofibrate is being used for the treatment of conditions such as increased cholesterol and fatty substance levels in the blood.
Fenofibrate decreased Covid-19 infection by up to 70% at concentrations that are safe and attainable with its standard clinical dose, the University of Birmingham noted.
Additional unpublished findings showed that the drug worked against the newly emergent SARS-CoV-2 variants such as the Alpha and Beta variants. The university added that further research is underway to analyse the drug’s efficacy against the Delta variant.
The US’ Hospital of the University of Pennsylvania and Hebrew University of Jerusalem in Israel are currently progressing two trials of the drug in hospitalised subjects with Covid-19.
Cholesterol-Lowering Drug Tested at Penn Medicine to Help Fight COVID-19
Let’s now return to the University of Pennsylvania article with this report: Cholesterol-Lowering Drug Tested at Penn Medicine to Help Fight COVID-19.
Can a drug used to treat high cholesterol also treat COVID-19? It’s a question researchers at Penn Medicine, in Philadelphia, are trying to answer.
Two different studies in laboratories found the drug Fenofibrate reduced COVID-19 infection by up to 70%. Doctors say if this works in actual patients, it could have a major impact by helping to slow the spread of the virus and save lives.
Cardiologist Dr. Julio Chirinos is leading the trial at Penn Medicine, testing to see if the drug commonly known as Tricor [Tricor is a brand name for the generic Fenofibrate]. Lab studies show it blocks the virus’s ability to bind to cells and replicate, which means it could prevent an infection from getting worse and spreading.
Chirinos says the research is promising, but still very early. “If it’s highly effective, it could have a major impact. We certainly hope so, but we don’t have that information yet,” he said.
It would have a major impact because the drug is easy to take. It’s a cheap and widely available oral medication used to help lower cholesterol and fatty acids in the blood.
Pieces All Fit
- Obesity is a huge risk factor for high cholesterol.
- Obesity is a huge risk factor for Covid complications.
- Hydroxychloroquine has mixed success because Covid appears to use a different mechanism in respiratory cells than kidney and liver cells.
- Fenofibrate appears to work on respiratory cells, kidney cells, and liver cells.
At $1.50 a day, Fenofibrate shows immense promise and it has few side complications including cytokine storms associated with other drugs.
As an amazing side benefit, it helps lower cholesterol.
Wow.
Correction
At one point above I accidentally said Penn State instead of University of Pennsylvania. Penn Medicine’s home base is the Hospital of the University of Pennsylvania (HUP), considered one of the better hospitals in the country.
Please Subscribe!
Like these reports? I hope so, and if you do, please Subscribe to MishTalk Email Alerts.
Subscribers get an email alert of each post as they happen. Read the ones you like and you can unsubscribe at any time.
If you have subscribed and do not get email alerts, please check your spam folder.
Mish
“Minor” issues with blood chemistry are proving highly predictive of patient outcomes in COVID infection. In particular, blood sugar. We have known from the beginning that diabetics with uncontrolled blood sugar are at especially high risk. We also know that the COVID disease raises blood sugar in patients, thus worsening outcomes and lengthening the duration/severity of the illness. I suspect that the new anti-diabetes drugs like Victoza could save lives in a clinical setting by sending patients’ blood sugar levels way down. But the wider take home message is worth hearing: All the things you should be watching anyway – blood pressure, blood sugar, blood fats, vitamin D levels – having good numbers with all of them helps you to fight off this infection with minimal long term consequences, just as doing so helps you with so many other health problems.
Dr. Jeremy Faust, an emergency medicine physician at Brigham and Women’s Hospital, is skeptical of boosters for the broader population so soon.
“The risks are unknown, and the benefits are unknown. I can’t, as a responsible physician, give someone advice, when I haven’t been able to weigh those two things,” Faust said, cautioning against taking a “shot in the dark.”
“The science on this is unavailable. And that’s not a place where we’ve been before,” Faust said, noting the risk of myocarditis has shown to happen more frequently after the second mRNA dose.
“What’s the third dose going to do?” Faust said. “Is a third dose going to hospitalize more people for myocarditis than we’re actually getting in return for the third dose of vaccine coverage? We literally don’t know.”
“We could be digging ourselves into a hole, for a very long time, where we think we can only keep Covid away by boosting every year,” Prof Eleanor Riley, an immunologist from the University of Edinburgh, told me.
currently conducting Phase II trials of a nitric oxide nasal spray.”