Lipid-lowering drug reduces viral load in Covid-19 with an efficiency of up to 70%

Lipid-lowering drug reduces viral load in Covid-19 with an efficiency of up to 70%
Lipid-lowering drug reduces viral load in Covid-19 with an efficiency of up to 70%

The drug fenofibrate, commonly used for abnormal blood cholesterol levels, has been able to reduce viral load in Covid-19 with up to 70% success.

Patient with suspected coronavirus at Turku hospital

In March 2020, at the dawn of the coronavirus pandemic, the World Health Organization announced Solidarity, a multinational clinical trial to compare treatments for Covid-19 patients. By the end of the year, a verdict was issued on four drugs: none were beneficial. Now, after months of suspension, it is decided to resume this largest test. Experts from different countries (Finland being the first) will test three new drugs: imatinib for cancer, an antibody called infliximab, which is used to treat autoimmune diseases, and the antimalarial artesunate.

While the development of coronavirus vaccines has become a huge global success, they are not suitable for everyone, such as people with hyperimmune disorders and those using immunosuppressive drugs. At the same time, only two drugs, as studies have shown, reduce mortality from Covid-19: the steroid dexamethasone and tocilizumab, a monoclonal antibody that blocks the interleukin-6 receptor. Both drugs do not target the virus itself, but suppress the excessive immune response in critically ill patients, thereby preventing a cytokine storm.

Scientists from the Universities of Birmingham and Keele in the UK, as well as the San Raffaele Research Institute in Italy and the Copenhagen Glycomics Center (Denmark) have proposed another treatment for those infected with coronavirus - fenofibrate. The research results are published in a recent article for the journal Frontiers in Pharmacology.

Fenofibrate is the international non-proprietary name of a drug with hypolipidemic, uricosuric and antiaggregatory effects. It is approved in most countries and is usually needed to lower levels of lipids, LDL cholesterol, and triglycerides by activating lipoprotein lipase and lowering the concentration of apoprotein CIII, which increases lipolysis and leads to the elimination of triglyceride-rich particles from plasma.

The coronavirus is known to enter the body thanks to its S-protein, which binds to the ACE2 receptor. The authors of the work decided to test a group of licensed drugs, including fenofibrate, to understand which ones will disrupt the interaction of ACE2 and the spike protein on the surface of SARS-CoV-2. Experiments have shown that fenofibric acid, an active metabolite of fenofibrate, induced dimerization of ACE2 and destabilized the spike receptor-binding domain, interfering with its binding to ACE2.

The scientists then tested the in vitro efficacy of fenofibrate in lowering viral load using the original strains of SARS-CoV-2 isolated in 2020. “Fenofibrate and fenofibric acid have been tested in two independent laboratories. Fenofibrate reduced viral load by about 18-65% within 24 hours - therefore, it can suppress primary infection. A decrease was also seen with fenofibric acid, albeit to a lesser extent. The results were then rechecked after 48 hours. Fenofibrate is still effective», - scientists write. At the same time, the effectiveness was achieved using safe concentrations of the drug.

Now the authors of the work are calling for the start of clinical trials of fenofibrate in hospitalized patients with Covid-19 - in addition to two studies that are ongoing at the hospitals of the University of Pennsylvania (USA) and the Hebrew University of Jerusalem (Israel).“Our data showed that fenofibrate may have the potential to reduce the severity of symptoms as well as spreading the virus. Given that this is an oral drug that is cheap and affordable, along with its long history of clinical use and safety, our research has global implications, especially in low- and middle-income countries, and for people who are not recommended or suitable for vaccines. " - summed up Dr. Eliza Vicenzi from the Scientific Institute of San Raffaele in Milan.

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