The World Health Organization (WHO) said on Wednesday a clinical trial in 52 countries would study three anti-inflammatory drugs as potential treatments for COVID-19 patients.
"These therapies - artesunate, imatinib and infliximab – were selected by an independent expert panel for their potential in reducing the risk of death in hospitalized COVID-19 patients," it said in a statement on the Solidarity PLUS trial.
The original Solidarity trial last year found that all four treatments evaluated - remdesivir, hydroxychloroquine, lopinavir/ritonavir and interferon - had little or no effect in helping COVID patients.
The WHO said artesunate, produced by Ipca, is used to treat malaria. In the trial, it will be administered intravenously for seven days, using the standard dose recommended for the treatment of severe malaria.The previously tested drug hydroxychloroquine is also a drug for malaria, and is also used as first-line treatment for systemic illnesses such as Systemic Lupus Erythematosus (SLE), an inflammatory disease causing rashes, sun sensitivity and bouts of rheumatic aches and fevers. It can also cause kidney injury.
The coronavirus, while primarily affecting the lungs and respiratory system, was found to have an effect on small blood vessels in its inflammatory process. As such, various drugs that work systemically (in all body parts) to minimize inflammation in vessels were thought to be helpful in managing COVID patients. Thus far, only corticosteroids (which are the most basic form of anti-inflammatory medicine) have been proven effective against severe and critical COVID-19.
Imatinib and infliximab are both biological drugs developed in recent years. These drugs use human proteins called monoclonal antibodies (or synthetic versions of them) to attack our immune system and help fight auto-immune diseases, where our body reacts against itself, as well as certain cancers.Imatinib, produced by Novartis and commercially known by the name Gleevec, is used to treat certain forms of blood cancers (leukemias). It works by inhibiting a protein called tyrosine kinase, which is in charge of many cellular mechanisms. Imatinib changed the outcome for patients diagnosed with chronic myeloid leukemia (CML), who used to have a prognosis of no more than five years. Today, the use of tyrosine kinase inhibitors (TKI's) gives over 80% survival rate after 10 years, according to a study published in the New England Journal of Medicine. In the Solidarity PLUS trial, it will be administered orally, once daily, for 14 days.
Infliximab, produced by Johnson and Johnson and commercially known as Remicade, is used to treat diseases of the immune system such as Crohn's disease, and also led to a complete change in outcomes for severe patients. In the trial, it will be administered intravenously as a single dose.Both biological drugs cost hundreds of dollars each. In Israel, biological drugs are approved in the health basket under strict restrictions.Biological medicine is the main focus in medicine development in recent years, following the approach of "personalized medicine". The idea is to invent drugs that use our own body's mechanisms and target them against specific mutations or defects that cause disease.