Researchers at UCSF have begun testing a mix of two of the most promising treatments for COVID-19 in the hope that the concoction will be the ‘golden ticket’ that everyone seeks to neutralize the coronavirus and reduce global anxiety.
Doctors conducting the study, which is sponsored by the National Institutes of Health, treated their first patient last week with a combination of brake drug, an antiviral drug developed to treat Ebola, and interferon, an anti-inflammatory drug used to treat people with multiple sclerosis.
The hope is that together the two drugs will cut the length and severity of the disease and reduce the number of deaths caused by SARS-CoV-2, the specific coronavirus that causes COVID-19.
“We’re looking for the golden ticket,” said Peter Chin-Hong, a professor of medicine and infectious diseases at UCSF, who is on the student team. “The gold medal will be a combination of drugs that will bring you to the sweet spot.”
Remdesivir, manufactured by Gilead Sciences of Foster City, interferes with the process by which the coronavirus replicates itself. A large study led by the federal government generated in late April when patients who were hospitalized who received intravenous inhibitor recovery recovered more rapidly than those who received a placebo.
Doctors have been using the brakes since then to treat seriously ill patients. The problem is that there is conflicting evidence as to whether brake drug reduces the number of deaths, so “it’s not a gold medal in my drug games,” Chin-Hong said. “It’s a silver medal winner.”
That’s where beta interferon comes in, he said. A recent study in the United Kingdom showed hospitals that inhale interferon like an asthma medicine are taking it harder. He said the preliminary study, which has not yet been peer reviewed, shows an 80% decrease in both deaths and the number of patients on breathing tubes compared to people on a placebo.
Interferon has also been reported to be working in laboratory studies on SARS, a coronavirus identified in China in 2003, and MERS, discovered in Saudi Arabia in 2012. These viral respiratory diseases cause similar symptoms to those infected with SARS-CoV-2 in humans. .
An added benefit, Chin-Hong said, is that interferon is readily available, relatively inexpensive and can be given at home to patients.
“That’s why interferon is the treasure at the moment,” he said.
The plan is to register patients with UCSF and about 100 other locations around the world. The 1000 or so patients in the study will all receive a brakesivir infusion. Half will also infer with interferon, while the other half will receive a placebo. The researchers will then study how the patients in each group respond over time.
The combination is necessary, Chin-Hong said, because inhibitor design is designed to attack the virus while reducing interferon inflammation. The inflammatory response, known as a cytokine storm, is a serious problem among COVID-19 patients whose immune system overreacts to the disease, exacerbates infections in the lungs and other organs.
If the two drugs work well together, researchers think they can use it as an outpatient treatment that can prevent hospitalizations. Gilead Sciences is studying a nebulized formula of inhibitor that can be taken at home.
“It would mean I have something I can give patients who can reduce hospitalizations, reduce deaths and reduce the need for a breathing tube,” Chin-Hong said. “All those things would make me feel excited.”
Art Reingold, a professor of epidemiology at the School of Public Health at UC Berkeley and not affiliated with the study, warned against hoping too high a level.
“It will be nice if it works,” Reingold said. “But a lot of things don’t do it.”
John Swartzberg, an infectious disease expert at the UC Berkeley School of Public Health, also downplayed the potential benefits of the two-drug combination. It is “perhaps a beacon of hope for those who are very sick of COVID-19, (but) this is certainly not a game-changer,” he said. “What we need is something at the other end of the spectrum of COVID-19: an oral med taken at the first signs of illness or after exposure. That would be a game-changer! ”
The two drugs are not the only ones that have shown promise. The steroid dexamethasone caused mortality significantly in seriously ill COVID-19 patients during a recent drug trial conducted by the University of Oxford. This finding marked the first time that any coronavirus treatment has proven that deaths occur.
Chin-Hong said brake inhibitors, dexamethasone and other treatments and techniques developed during the pandemic have already reduced deaths in hospitals around the country, offering hope and an incentive to intensify the search for more effective treatments.
Peter Fimrite is a staff writer for the San Francisco Chronicle. Email: [email protected]. Twitter: @pfimrite
