In June 2020, RECOVERY trial from a group of researchers in Oxford University UK reported use of low-cost dexamethasone1 for treatment of severely ill COVID-19 patients by reducing inflammation. Recently, a protein-based drug, called Aviptadil, has been fast tracked by FDA for performing clinical trials on moderate to severely ill COVID patients. The trial began on 1st July 2020 and the initial results are very encouraging.
The race is on to develop safe and efficacious drugs for the treatment of COVID-19, which has grappled the entire world and caused significant economic and health related challenges for more than 200 nations across the globe. Although a few small molecule anti-viral drugs have been approved as a remedial measure, there are associated side effects of these small molecule drugs. The hunt is on for specific protein-based drugs that include monoclonal antibodies2 which are more specific and have little side effects. In addition, from a long-term perspective of protecting the global population, the entire world is eagerly waiting for a safe and effective vaccine that will help develop active immunity against the virus and bring life back to normalcy as it was before COVID-19.
Aviptadil is a formulation of synthetic Vasoactive Intestinal Polypeptide (VIP). VIP was first discovered in 1970 by Dr Sami Said, a pulmonary medicine specialist. It is present in high concentrations in the lungs where it is involved in relaxation of airways and pulmonary vessels. VIP has also been identified as a potent anti-inflammatory factor, which acts by regulating the production of both anti- and pro-inflammatory mediators3 and functions by blocking inflammatory cytokines.
Use of Aviptadil in the recently approved clinical trials has led to rapid recovery of patients from respiratory failure in critically ill Covid-19 patients. Upon administering the drug, it got rid of their lung inflammation, improved their blood oxygen levels and reduced the inflammatory markers by more than 50% in more than 15 patients4. However, further data from the clinical trial is required to establish the safety and efficacy of Aviptadil in a larger number of patients including patients with less severity of illness to ensure that similar observations are seen.
- Soni, R, 2020. Dexamethasone: Have Scientists Found Cure for Severely Ill COVID-19 Patients? Scientific European. Published on August 14, 2020. Available online at https://www.scientificeuropean.co.uk/dexamethasone-have-scientists-found-cure-for-severely-ill-covid-19-patients/
- Soni, R, 2020. Monoclonal Antibodies and Protein Based Drugs Could be Used to Treat COVID-19 Patients. Scientific European. Published on August 14, 2020. Available online at https://www.scientificeuropean.co.uk/monoclonal-antibodies-and-protein-based-drugs-could-be-used-to-treat-covid-19-patients/
- Delgado M, Abad C, Martinez C, Juarranz MG, Arranz A, Gomariz RP, Leceta J. Vasoactive intestinal peptide in the immune system: potential therapeutic role in inflammatory and autoimmune diseases. J Mol Med (2002) 80:16–24. DOI: https://doi.org/10.1007/s00109-001-0291-5
- Youssef JG, Zahiruddin F, Al-Saadi M, Yau S, Goodarzi A, Huang HJ, Javitt JC. Brief Report: Rapid Clinical Recovery from Critical COVID-19 with Respiratory Failure in a Lung Transplant Patient Treated with Intravenous Vasoactive Intestinal Peptide. Preprints 2020, 2020070178 DOI: https://doi.org/10.20944/preprints202007.0178.v2