Heartburn Medications Among Possible Coronavirus Treatments

Vitamin C infusions have emerged as an effective way to protect the lungs from acute injury, as well as a powerful treatment for sepsis. Researchers in Virginia will test a three-day regimen of vitamin C infusions to see if they prevent lung injury in seriously ill patients with COVID-19.

In New Orleans and New York, two cities affected by the coronavirus, researchers will test hyperbaric oxygen therapy in 48 COVID-19 patients who require respiratory assistance. Delivered in a full-body oxygen chamber, the treatment is believed to increase the amount of dissolved oxygen in the blood and promote its delivery to delicate tissues throughout the body. It can also reduce the intensity of the immune system’s inflammatory response and even kill the virus directly. Traditionally, therapy has been used in divers who get the bends if they surface too quickly; For COVID-19 patients, scientists hope it will reduce the time for mechanical ventilation and even the need for mechanical ventilation, and to avoid kidney damage.

Reduced immune overreaction

Doctors soon realized that for some patients with COVID-19, the immune system’s response to coronavirus infection was more dangerous than the virus itself. Now they are eager to find medications that can keep the immune system under control.

Colchicine reduces inflammation in the tissues surrounding the heart, a condition known as pericarditis, and reduces swelling and inflammation in gout patients. A great trial in the USA. The US, Canada and Spain will evaluate 6,000 patients at high risk of developing severe cases of COVID-19 to see if colchicine reduces their chances of becoming seriously ill. At UCLA, researchers will test the drug’s ability to reduce heart damage in patients with COVID-19 who have already shown signs of heart injury.

Ruxolitinib (marketed as Jakafi) is used to treat rare blood cancer myelofibrosis and graft-versus-host disease, which causes the transplant recipient’s immune system to reject a new organ. It inhibits inflammation, controls the body’s immune responses, and appears to induce the death of some types of cancer cells. Researchers in Denver and St. Louis plan to test it as a way to reduce the overreaction of the immune system in COVID-19.

Etoposide (Etopophos) is a chemotherapy drug used to treat testicular cancer, lung cancer, lymphoma, leukemia, neuroblastoma, and ovarian cancer. It is also administered to patients with hemophagocytic lymphohistiocytosis, a life-threatening overproduction of immune cells with effects similar to those seen in many with COVID-19. Researchers at Massachusetts General Hospital in Boston will see if it prevents cytokine storms when administered on hospital admission and on Day 4.

Sirolimus (Rapamune) is an immunosuppressive medication that is taken to reduce episodes of rejection in organ transplant patients. It will be tested in a small trial at the University of Cincinnati.

Enlisting Rheumatoid Arthritis Medications

Many new medications for this autoimmune disease are based on monoclonal antibodies, proteins of the immune system that are designed to target your goals and activate or deactivate them. With COVID-19, the hope is to turn off, or at least redial, the body’s biological defense mechanisms.

Baricitinib (Olumiant) suppresses the immune response by the same means as ruxolitinib. At the University of Colorado, Denver, researchers will conduct a small trial to assess whether COVID-19 patients are much better off baricitinib than usual care.

Regeneron Pharmaceuticals Inc. will test its drug sarilumab (Kevzara) in a large multi-center trial to see if its known action in rheumatoid arthritis, which suppresses so-called cytokine storms, the inflammatory response involved in COVID-19, would reduce a key measure of inflammation and prevent hospitalization, mechanical ventilation, or death.

Tocilizumab (Actemra) may prevent cytokine storms, and will be tested in a small recently hospitalized patient trial at the University of Chicago and in a large international trial sponsored by the drug’s manufacturer, Hoffmann-La Roche. In a small study in China, the 21 patients with severe or critical COVID-19 saw their body temperatures return to normal after treatment with tocilizumab, 15 reduced their need for supplemental oxygen by five days, and measures of inflammation returned to normality in at least half. Lung lesions disappeared in 19 patients, and all 21 were discharged 10 to 31 days after treatment, with no adverse reactions reported.

Disrupt cell entry or viral replication

For the coronavirus to do its dirty work, it must enter a host cell and make copies of itself. These drugs aim to prevent one of those things from happening.

Camostat mesylate is used in Japan to treat reflux esophagitis and chronic pancreatitis. The researchers believe that it is a protease inhibitor that can alter the coronavirus’s ability to latch on and enter lung cells. In tests with infected mice, it reduced deaths from 100% to between 30% and 35%. Yale researchers will conduct a clinical trial with 114 participants to see if the drug suppresses viral load and reduces the severity of symptoms in patients with COVID-19 who start taking it within two days of diagnosis.

Losartan (Cozaar) and telmisartan (Micardis) are angiotensin receptor blockers that are used to treat high blood pressure. Because they bind to receptors that the coronavirus uses to latch on and enter cells, these drugs can prevent the virus from supporting or causing serious damage to the lungs. A pilot study of telmisartan at the University of Hawaii will assess whether it reduces the severity of the disease if used early in infection. In San Diego County, losartan will be tested to see if it prevents patients from progressing to a critical illness. The same drug will be tested in Minnesota patients with mild and severe COVID-19 and in Kansas patients with severe disease.

Leronlimab, the first in a new class of HIV drugs and still in clinical trials, is believed to inhibit the entry of the coronavirus into cells and possibly reduce the likelihood of a cytokine storm. In a couple of trials, Montefiore Medical Center in New York will test the drug in patients with mild and severe cases of COVID-19 to see if it improves symptoms and reduces the risk of death.

Who knows how they might work?

In some cases, clinical trials are underway despite researchers still not sure how or why the drugs they are testing can make a difference. They may have a chemical structure that appears to adhere to the virus. They can correct some factor that predisposes a person to become seriously ill or intervene in some disturbed process in patients with COVID-19.

Famotidine, the drug known to American consumers as Pepcid, will be tested as a COVID-19 treatment under a $ 20 million Defense Department contract. Case reports from China noted for the first time that among COVID-19 patients at high risk of becoming seriously ill, those who routinely took famotidine for gastric reflux fared much better than those who took a more expensive antacid. of a different kind. Doctors at Columbia University in New York picked up similar signals, and a group of drug profiles working for the Pentagon identified the drug as a compound capable of binding to a distinctive coronavirus enzyme, potentially potentially disrupting the virus’s action.

Tranexamic acid, or TXA, is a synthetic version of the natural protein that helps the blood to clot. It has long been used to treat women with excessive menstrual bleeding and to stop bleeding in patients with surgery and trauma. One of the most mysterious symptoms of COVID-19 is coagulopathy. That abnormality results in dangerous blood clots forming throughout the body, but in patients who are seriously ill, it can cause bleeding in some organs. Researchers at the University of Alabama will conduct two trials to see if the drug could help prevent COVID-19 patients from becoming seriously ill by correcting the balance of clotting factors.

Dapagliflozin (Farxiga) is a widely publicized medication taken by people with type 2 diabetes to reduce the likelihood of hospitalization for heart failure. The drug’s manufacturer, AstraZeneca, is sponsoring a large trial in Kansas City, Missouri, to determine if it might reduce rates of respiratory failure and other complications in COVID-19 patients with underlying conditions such as diabetes, cardiovascular disease, heart failure, and discharge. blood pressure.

Fluvoxamine (Luvox) is an antidepressant used primarily to treat obsessive compulsive disorder. Its main job is to increase the supply of serotonin to the brain, but it has many incidental effects. Researchers in St. Louis will enroll 152 patients to assess whether the drug, when used early in COVID-19 infection, can prevent more serious complications, such as shortness of breath.