Corticosteroid inhalers used by asthma patients may help treat COVID-19, researchers to begin human clinical trials
The ultimate goal of the trial is to analyse if the Budesonide inhaler can be used as a low-cost and easily available early intervention therapy for COVID-19 patients to reduce the risks of severe respiratory illness.
The effect that the SARS-CoV-2 virus has on the human respiratory system is very well known now. Recent studies on COVID-19 have shown that the pathogenesis (the manner in which the disease develops) of the virus in the body involves the macrophages (specialised cells that detect and destroy harmful virus or bacteria that have entered the body) of the lungs releasing cytokines which end in hyper-inflammation and a cytokine storm.
Steroids, it is stipulated, can inhibit the adhesion and action of cytokines, and by this regulation of the immune response, these drugs can prevent the onset of acute respiratory distress syndrome or ARDS. Keeping this effect of steroids in mind, researchers from Oxford University and the Queensland University of Technology are collaborating on starting human clinical trials of inhaled corticosteroids (ICS) therapy on COVID-19 patients.
What inhaled corticosteroids can do
There is no way you should confuse ICS with the steroids you might have heard some athletes use. ICS, according to the American Academy of Allergy, Asthma and Immunology, are a class of medications used to treat asthma. They are used via an inhaler and must be taken regularly by asthma patients to reduce the inflammation of the respiratory system.
It’s considered to be the most effective medication for asthma patients in the long term because of its high success rates in controlling and managing this respiratory illness. Some of the most common ICS include Beclomethasone, Budesonide, Ciclesonide and Mometasone. The new clinical trials for the use of ICS to treat COVID-19 patients — registered as the STOIC (STerOids In COVID-19 ) trials — is based on the belief that early administration of ICS to COVID-19 patients can reduce their risks of severe respiratory illness.
STOIC trials parameters and scope
The researchers conducting the STOIC clinical trials have already started recruiting patients at the Churchill Hospital in Oxford, UK, and will include a total of 478 COVID-19 positive patients. Led by Dan Nicolau, associate professor at the Queensland University of Technology, the trials will aim to evaluate the efficacy of ICS therapy in participants with early COVID-19 illness (mild to moderate symptoms) as compared to standard care protocols for the same patients. The trial will monitor the effect of ICS therapy — particularly the corticosteroid Budesonide — on body temperature, blood oxygen saturation level, viral load and other symptoms.
The trial is excluding patients with a known allergy to Budesonide, those who are already taking ICS therapy due to preexisting asthma or respiratory illness, and those who have to be hospitalised due to severe COVID-19 respiratory symptoms straight away. The participants will be evaluated on entry into the trial and this baseline would be followed up on the seventh, 14th and 28th days. If any patient requires hospitalisation within 28 days of entry into the trial, that would be their endpoint in the study.
The ultimate goal of the trial is to analyse if the Budesonide inhaler can be used as a low-cost and easily available early intervention therapy for COVID-19 patients to reduce the risks of severe respiratory illness. The researchers expect the results of the trial in September 2020, but also anticipate that conclusive and positive outcomes of this trial might lead to panic buying and hoarding of these inhalers.
Always keep in mind that taking any medication without a doctor’s recommendation is inadvisable and can lead to severe side-effects.
For more information, read our article on Acute Respiratory Distress Syndrome.
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