COVID-19 Drugs: John Hopkins Researchers Recommend Further Clinical Investigation Of Blood Pressure Drug Prazosin To Treat Cytokine Storms
Source: COVID-19 Drugs May 20, 2020 4 years, 6 months, 1 day, 20 hours, 47 minutes ago
COVID-19 Drugs: According to medical researchers from Johns Hopkins Kimmel Cancer Center, the high blood pressure drug
Prazosin if given early enough, could potentially reduce the risk of death from the cytokine storms that arise as a complication of COVID-19 disease.
The blood pressure drug Prazosin, is an US FDA a U.S. Food-approved alpha blocker that relaxes blood vessels, and it may specifically target an extreme inflammatory process often referred to as the cytokine storm syndrome (CSS) that disproportionately affects older adults with underlying health conditions, and is associated with disease severity and increased risk of death in SARS-CoV-2 coronavirus infections.
Utilizing Prazosin to pre-emptively to address COVID-19-associated hyperinflammation of the lungs and other organs has the potential to reduce deaths in the most vulnerable populations according to the researchers.
In their research findings published in the
Journal of Clinical Investigation, the medical scientists caution that although they believe if given early enough after viral exposure, Prazosin could prevent some deaths, it would not work in individuals with advanced stages of the disease.
https://www.jci.org/articles/view/139642
The researchers also emphasize that controlled clinical trials for this novel use of prazosin are needed before it can be safely recommended. The investigators published the study, hoping to stimulate rapid efforts to conduct such trials.
The medical researchers described how they have been working in collaboration with researchers in the Johns Hopkins Divisions of Rheumatology and Infectious Diseases, and Departments of Neurology and Neurosurgery, to identify chemical ways of safely blocking the actions of catecholamines and cytokine responses.
It has been observed that catecholamines together with cytokines enhance the inflammatory process that leads to severe COVID-19 symptoms, explains Dr Chetan Bettegowda, M.D., Ph.D., Jennison and Novak Families Professor of Neurosurgery, who is senior author of the paper.
Dr Bettegowda told Thailand Medical News, "The purpose of our study is to make the biomedical community aware of the potential of this approach and to stimulate additional basic and clinical research. Although, we are excited about this idea, we stress that a clinical trial is necessary to know if this intervention will help COVID patients, and that is where we are focusing all of our attention.”
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In animal models (mice) of c
ytokine storm syndrome or CSS, they found that prazosin, commonly used to treat blood pressure, prostate gland enlargement and other conditions blocked catecholamines (hormones released by the adrenal glands when the body is under stress), reduced cytokine levels, and increased survival after exposure to agents that trigger cytokine storm responses similar to those observed in COVID-19.
In drug repurposing studies, pharmaceuticals that target cytokine storm syndrome have been found to reduce the risk of death from other viral illnesses by up to 55%, according to preliminary results from a retrospective clinical study.
The drug Prazosin is taken by mouth and costs less than US$20 per month in the United States and even cheaper in countries like Thailand and India, and has been safely taken by millions of individuals over the last twenty years. This should enable highly expedited clinical trials in individuals early after exposure to the SARS-CoV-2 virus, say the researchers.
Dr Bettegowda further added, "All drugs can have unanticipated side effects when used in new situations, so it is critical to evaluate the effectiveness and side effects of this drug in controlled clinical trials before it can be safely recommended for public use. This is particularly important for drugs like prazosin, which are already sold in pharmacies."
Research fellow and lead author of the report, Dr Maximilian Konig, says a vaccine remains the best long-term hope to prevent deaths from COVID-19 but notes, at present, there are hundreds of individuals throughout the world who are dying every day.
He commented, "Prazosin is already widely available, known to be safe and inexpensive, and the regulatory path for use in individuals exposed to the virus is straightforward."
The cytokine storm syndrome CSS treatment was granted US Food and Drug Administration approval to be studied in a clinical trial for individuals with COVID-19.
The researchers are hoping to collaborate with other institutions and hospitals to initiate clinical trials of Prazosin soon.
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