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TOKYO (Reuters) – In the global quest for coronavirus treatments, a Japanese antiviral drug known as Avigan has won applause from Prime Minister Shinzo Abe and $ 128 million (£ 104.2 million) in government funding.
But it is not the only game in town.
Camostat, a 35-year-old pancreatitis drug manufactured by Osaka-based Ono Pharmaceutical Co, has captured the interest of scientists in Japan and abroad with little fanfare or state assistance.
The two compounds are among dozens of tests around the world, and illustrate how the race to develop treatments and vaccines is still open despite politicians like Abe and United States President Donald Trump promoting the potential benefits of certain medicines.
Gilead Science Inc’s remdesivir has taken the lead after promising preliminary results of emergency approval in the United States and Japan. While remdesivir has shown promise in reducing recovery times for hospitalized patients, the search continues with additional treatment options.
Interest in Avigan soared in March after a Chinese official said it appeared to help patients recover from COVID-19, the flu-like infection caused by the coronavirus. He is now the subject of at least 14 clinical trials. Amid a global drop in stocks, stocks at Fujifilm rocketed to record levels.
Abe has called for Avigan to be approved for use later this month if these trials are effective, an unprecedented rate, particularly for a drug known to cause birth defects.
The Abe administration has committed to giving away free supplies of the drug, with some 43 countries making formal requests. Fujifilm President Shigetaka Komori has long supported Abe, although the cabinet has denied that there is any connection between his relationship and the promotion of the Avigan government.
The use of Avigan is decided by the doctors and its approval will depend on the medical and scientific evaluation in due time, said Fujifilm spokeswoman Kana Matsumoto.
“The use of Avigan has nothing to do with the relationship between the prime minister and a particular company,” he said.
DESTRUCTIVE TO THE FETUSES
Avigan, known generically as favipiravir, was developed in the late 1990s by a company that Fujifilm later acquired as part of its transition from photography to healthcare. The drug works by short-circuiting the reproduction mechanism of certain RNA viruses such as influenza.
Avigan can be taken as a pill, which would make it more accessible than Gilead’s remdesivir, currently administered only as an intravenous infusion. But the mechanism that makes Avigan effective against viruses also makes it destructive to the rapid cell growth of fetuses.
After being tested against a variety of viruses, Avigan was finally approved in Japan in 2014, but only for emergency use against influenza epidemics, and was licensed in China, where it has since been discontinued.
Also clinically unproven is a camostat mesylate. Developed by Ono Pharmceutical, most famous for its successful cancer drug Opdivo, the camostat is a protease inhibitor that has been used primarily to treat pancreatitis and some types of cancer. But previous laboratory and animal tests against SARS-CoV-1 showed that it has antiviral functions, and can be safely administered in doses high enough to match the concentrations that were effective in the laboratory.
A study published in the scientific journal Cell in March found that the camostat blocks an enzyme essential for the entry of the coronavirus into the lungs, drawing the researchers’ interest. One of them was Dr. Joseph Vinetz, a professor at Yale School of Medicine, who is ready to launch a clinical trial of the camostat.
“It has a 35-year history, so it appeared to be a very safe drug,” he said. “I said we have to prove it. I am a doctor and we are desperate for anything we can give people.”
Vinetz is still trying to raise money for the trial.
“I am 100% sure that we needed to start this test a month ago. And we can have a definitive result in a month.”
Ono launched the camostat, known commercially in Japan as Foipan, as a treatment for chronic pancreatitis in 1985 and postoperative reflux esophagitis in 1994. The company now supplies the drug for COVID-19 studies in Japan and abroad, according to the spokesperson. Yukio Tani.
Itzchak Levy, from the Sheba Medical Center in Israel, launched a self-funded thermostat trial in April. “So far we have recruited 14 patients and we expect further recruitment,” said Levy.
Another trial underway at the University of Kentucky is testing whether the camostat can inhibit the virus’s preferred route to human cells, and with hydroxychloroquine, the anti-malaria drug promoted by Trump, it also blocks the back door, which increases the effectiveness of the treatment.
The science behind the mechanism of action and tolerance of the camostat in patients “is why we were excited about its potential,” said Elijah Kakani, an assistant professor at the university involved in the research. “However, at this point we need to moderate our enthusiasm and be objective in our evaluation of this drug for the problem at hand.”
(Additional report by Sangmi Cha in Seoul; Elyse Tanouye and Carmel Crimmins edition)
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