Potential COVID-19 Drugs Discovered So Far
1. Hydroxychloroquine and Chloroquine
These antimalarial drugs have quickly grabbed the headlines because of their arguable potential as possible COVID-19 treatments and a lot of opposition to their use, mainly from scientists and healthcare agencies. Several healthcare authorities have raised concerns regarding their use as they could be potentially dangerous for COVID-19 patients and people with existing heart disease.
In April 2020, the Heart Rhythm Society, American College of Cardiology, and American Heart Association together released a new guidance to provide critical cardiovascular considerations when using azithromycin and hydroxychloroquine to treat the new coronavirus.
Recently, the European Medicines Agency posted a reminder of the risk of serious side effects associated with the use of hydroxychloroquine and chloroquine in COVID-19 treatment.
The agency mentioned in a news release that these drugs are known to potentially cause kidney and liver problems in addition to heart rhythm problems. It also wrote that heart rhythm problems could worsen if the drugs are used in combination with antibiotic azithromycin and other drugs with similar effects on the human heart.
In the second week of April 2020, results of a Gilead Sciences cohort analysis of the use of investigational drug remdesivir in COVID-19 patients were published in the New England Journal of Medicine. Remdesivir is one of the company’s antiviral drugs and was given to COVID-19 patients through a compassionate use program.
According to Gilead, 47% of the patients involved in the analysis were discharged from the hospital and 68% showed improvement in oxygen-support class after receiving at least one dose of remdesivir. Furthermore, 57% of patients on mechanical ventilation were extubated. In April and May 2020, Gilead is expected to release results from a couple of phase 3 trials assessing the effectiveness of remdesivir in severe and moderate COVID-19 patients.
According to a draft report accidently published online by the WHO, Gilead has failed to achieve success with remdesivir in a Chinese clinical trial involving adult hospitalized COVID-19 patients. Results from a study that showed the drug’s failure in the randomized trial have now been removed from WHO’s website.
Gilead’s chief medical officer recently tweeted that information from the study was prematurely posted on the WHO website, adding that the results are inconclusive. Furthermore, the tweet said that the online post inappropriately characterized the study.
This investigational drug from RedHill Biopharma was used in a recent Israeli experimental drug trial as a COVID-19 treatment along with hydroxychloroquine background therapy and other standard of care procedures. Two patients with confirmed coronavirus infection involved in the trial showed improvement not many days after starting the treatment.
US doctors Dr. Jean-Jacques Rajter and his wife Dr. Juliana Cepelowicz-Rajter have started to use Ivermectin, an anti-parasitic drug, alongside the combination of drugs – zinc sulfate, azithromycin, and hydroxychloroquine – to treat COVID-19 patients at Broward Health Medical Center. Dr. Rajter is going to publish a scientific paper including his findings and information about this new approach to treat the novel coronavirus.
In April 2020, Washington University School of Medicine in St. Louis announced the investigation of the use of psychiatric drug fluvoxamine to relieve “cytokine storm,” a life-threatening exaggerated immune system response, in COVID-19 outpatients. The trial will help find out whether the antidepressant could be repurposed for the new coronavirus infection.
It is another drug that will be under clinical trial to evaluate its potential to control the overreaction of the immune system in COVID-19 patients. The blood cancer drug and Bruton tyrosine kinase inhibitor from AstraZeneca will be tested to know whether it could be used in supportive care for COVID-19 patients to reduce their need for assisted ventilation, and their mortality.
7. Inhibitors of SARS-CoV-2
A group of Chinese and Australian scientists recently published their work on the identification of six drug candidates targeting the main protease of SARS-CoV-2 in the journal Nature. The six inhibitors of the viral protease are PX-12, shikonin, carmofur, tideglusib, disulfiram, and ebselen. The researchers used high-throughput screening, virtual drug screening, and structure-assisted drug design to test over 10,000 compounds as potential inhibitors of the protease and identify the six most promising ones.
Recently, SOM Biotech announced the in vitro confirmation of three inhibitors of the 3CL proteases of MERS-CoV, SARS-CoV, and SARS-CoV-2, viz. cynarine, prexasertib, and eravacycline as new COVID-19 treatments. The pharmaceutical company used its AI-based screening technology SOMAI PRO to identify the drug candidates. It worked alongside South Korea’s Ewha Womans University to discover the new COVID-19 therapies.
Early in April 2020, Eli Lilly and Company announced the investigation of oral JAK1/JAK2 inhibitor baricitinib as a possible treatment for COVID-19. Marketed as Olumiant, the inhibitor is used to treat rheumatoid arthritis in adults. The research will be done alongside the National Institute of Allergy and Infectious Diseases in NIH-led Adaptive COVID-19 Treatment Trial.
Lilly also announced the Phase 2 clinical testing of anti-Angiopoietin 2 investigational selective monoclonal antibody LY3127804. The trial will study the effectiveness of the monoclonal antibody in reducing the requirement for mechanical ventilation or the risk of acute respiratory distress syndrome (ARDS) in COVID-19 patients.
In March 2020, the Montreal Heart Institute launched the Colchicine Coronavirus SARS-CoV-2 Trial or COLCORONA, a new clinical study on potential coronavirus treatment colchicine, in Canada. The study will focus on reducing the risk of pulmonary complications and related deaths in COVID-19 patients with the help of the ancient, common anti-inflammatory drug.
The first two US sites involved in the study are the University of California, San Francisco and the New York University School of Medicine. The researchers will use a modern contactless approach and send the drug directly to the homes of recruited patients within 48 hours of them being diagnosed with COVID-19.
11. Avigan Tablet
In mid-April 2020, Japan’s Fujifilm Toyama Chemical sped up the production of Avigan Tablet, the company’s influenza antiviral drug, to help treat COVID-19 patients. Parent company Fujifilm Corporation also allocated additional production capacity at its Japanese high purity chemicals company Fujifilm Wako Pure Chemical Corporation to accelerate the supply of the antiviral.
Carrying the generic name favipiravir, the antiviral was announced to be under phase 3 clinical trial in March 2020. The trial assesses the drug’s efficacy and safety in COVID-19 treatment in Japan. In the following month, Fujifilm announced the phase 2 trial of the drug for coronavirus patients in the US.
12. Ibudilast and Sobetirome
Recently, Yale University announced the launch of a clinical trial evaluating the efficacy and safety of macrophage inhibitory factor inhibitor ibudilast or MN-166 in COVID-19 treatment, especially in the treatment of COVID-19-related ARDS.
The trial will be launched in partnership with MediciNova, which develops the drug for use in the treatment of progressive multiple sclerosis, amyotrophic lateral sclerosis, and methamphetamine addiction. Not many days before announcing this launch, Yale researchers started to lay the groundwork for clinical trials of the university’s lung fibrosis drug sobetirome showing promise in the treatment of ARDS in COVID-19 patients.
13. Death Penalty Drugs
Early in April 2020, US doctors and medical experts appealed to correctional departments of death penalty states in the country to release stockpiled drugs, including paralytics and sedatives, used in lethal injection executions.
Fentanyl, rocuronium bromide, vecuronium bromide, and midazolam are among popular death penalty drugs that are short in supply in the US and could be used to intubate COVID-19 patients and enable mechanical ventilation of coronavirus patients close to death.