Study Shows Ramatroban, A Thromboxane A2 & Prostaglandin D2 Receptor Antagonist Can Be Used To Treat COVID Respiratory Distress And Hypoxemia
Source: COVID-19 Drugs - Ramatroban Jan 03, 2022 2 years, 10 months, 3 weeks, 1 day, 1 hour, 18 minutes ago
COVID-19 Drugs: A small clinical study conducted by researchers from the Charak Foundation-California-USA, Regulatory Wisdom-India, the EyeSight Eye Hospital and Retina Centre-India and the University of California Irvine-USA has found that the drug Ramatroban, which is a thromboxane A2 & prostaglandin D2 receptor antagonist can be used to treat COVID respiratory distress and hypoxemia.
The study findings were published on a preprint server and are currently being peer reviewed.
https://www.researchsquare.com/article/rs-474882/v6
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Hypoxemia or below-normal level of oxygen in the blood, often accompanying COVID-19 related pneumonia is dispositive for hospitalization and mechanical ventilation and contributes to increased risk of mortality. Other than oxygen supplementation, there is no treatment that resolves hypoxemia in COVID-19 pneumonia.
In May 2020, the Indian drug regulatory body, DCGI granted emergency approval for the drug 2-deoxy-D-glucose
(2-DG) developed by Institute of Nuclear Medicine and Allied Sciences, a lab of DRDO, in collaboration with Dr Reddy’s Laboratories, Hyderabad, as an adjuvant drug to treat hospitalized COVID-19 patients and also to reduce supplemental oxygen dependence. It was reported that their Phase III clinical trial results showed that this molecule helps in COVID-19 hypoxemia and also faster recovery of hospitalized patients and reduces supplemental oxygen dependence.
https://www.thailandmedical.news/news/breaking-india-approves-2-deoxy-d-glucose-2-dg-as-an-adjuvant-to-treat-covid-19-patients-and-reduce-supplemental-oxygen-dependence
However subsequently findings showed that the Indian study was just another typical substandard clinical trial the country was famous for and the drug did not really have any benefits.
In this new
COVID-19 Drugs study, it was found that COVID-19 pneumonia sustains a massive increase in lipid mediators, especially thromboxane A2 >> PGE2 > PGD2.
Thromboxane A2 induces pulmonary venoconstriction, increases pulmonary capillary pressure and contributes to pulmonary edema. High thromboxane A2 metabolite levels are strongly associated with respiratory failure and mortality in hospitalized COVID-19 patients.
Ramatroban (INN) (also known
as Bay-u3405) is a thromboxane receptor antagonist. It is also a DP2 receptor antagonist. It is indicated for the treatment of coronary artery disease. It has also been used for the treatment of asthma.
It is an inexpensive, orally bioavailable drug that also goes under the name of Baynas® made by Bayer Yakuhin Ltd., Japan.
In this small clinical study, Ramatroban was administered to patients with COVID-19 pneumonia and hypoxemia to explore the effect of thromboxane A2 antagonism on clinical symptoms and outcomes.
The study involved a retrospective case series comprising 4 consecutive outpatients, 22 to 87 years of age, with COVID-19 pneumonia and hypoxemia treated with ramatroban between April and July 2021 in India.
The primary outcome measure was blood oxygen saturation using pulse oximetry (SpO2). Secondary outcome measures were respiratory distress and need for hospitalization.
The
Four COVID-19 outpatients had developed progressive respiratory distress and hypoxemia. Within 12-36 hours of the first dose of ramatroban, all four patients experienced increase in SpO2 and decrease in respiratory distress, which obviated hospitalization. Continued treatment for 5 days was associated with complete resolution of respiratory distress and hypoxemia.
Th study findings showed that ramatroban was able to resolve conditions of hypoxemia and also respiratory distress.
To date, there is a dire unmet medical need for drugs that target the hemodynamic, prothrombotic, and maladaptive immune responses that lead to pneumonia and respiratory failure following SARS-CoV-2 infection.
Ramatroban as an anti-vasospastic, broncho-relaxant, anti-thrombotic and immunomodulatory agent, addresses the fundamental host response mechanisms underlying respiratory and critical organ failure in COVID-19.
Thailand
Medical News recommends that Ramatroban merits additional detailed studies in proper large randomized clinical trials formats as these results only then might offer hope for a cost-effective treatment.
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