Arthritis drug offers COVID hope

A drug used to treat arthritis may reduce the risk of dying in elderly patients with COVID-19.

Baricitinib, usually used to treat rheumatoid arthritis, was given to 83 patients with a median age of 81 suffering from moderate to severe COVID-19 infection, in an early stage study led by scientists from the Imperial College, London, and the Karolinska Institutek, Sweden.

“In the study, the patients, who were in multiple hospitals across Italy and Spain, had a 71 per cent reduced risk of dying compared to patients who had not taken the drug. The study also found that 17 per cent of patients who were given the drug died or needed to go on a ventilator, compared to 35 per cent in the control group who were not given the medication,” the study’s authors said in a news release.

The study’s co-lead author, Professor Justin Stebbing, from the Department of Surgery and Cancer at Imperial College, said: “We urgently need to find more effective treatments for COVID-19 while we wait for a vaccine to become widely available. This is one of the first COVID-19 treatments to go from computer to clinic and laboratory. It was first identified by an AI (artificial intelligence) algorithm in February, which scanned thousands of potential drugs that could work against this virus.

“The study suggests this drug can aid recovery of patients with moderate to severe COVID-19 and may provide a new weapon in our arsenal against the virus. Large-scale clinical trials of this drug, to further investigate its potential, are now underway”.

Baricitinib is currently administered to adult patients who can’t use other anti-rheumatic drugs.

In the research, scientists grew miniature human organs in the lab, called organoids, to investigate how the drug might work against COVID-19. The findings revealed the drug may help by reducing organ damage caused by inflammation, and by blocking the virus entering human cells.

“When infected with the COVID-19 virus, the body releases different types of inflammatory molecules, called chemokines and cytokines. These molecules act as the early warning system for the body, telling the immune system the body is under attack.

“However, in the case of COVID-19, particular cytokine and chemokines, including those called interleukins and interferons, cause this warning system to spiral out of control, and trigger a so-called ‘cytokine storm’. This cytokine storm not only causes significant damage to the body’s organs, but the study revealed it also helps the virus gain access inside human cells.”

The study revealed that the cytokine interferon increases the number of receptors for the virus, allowing the virus into the body’s cells.

Baricitinib blocks this process.

Arthritis Australia says baricitinib blocks an enzyme that “helps the transmission of signals from the surface of a cell, which normally will cause increased inflammation. “By blocking these signals baricitinib helps reduce inflammation in rheumatoid arthritis, resulting in less pain, swelling and stiffness and reduced joint damage.”

It usually helps patients withing two to four weeks and is administered once a day by tablet. It is associated with an increase in infections and is not prescribed if a patient has an active infection of any kind.

Australian health authorities say the risk of serious illness from COVID-19 increases with age. The highest rate of fatalities is among older people, particularly those with other serious health conditions or a weakened immune system.

The US Centers for Disease Control and Prevention (CDC) concurs.

“As you get older, your risk for severe illness from COVID-19 increases. For example, people in their 50s are at higher risk for severe illness than people in their 40s. Similarly, people in their 60s or 70s are, in general, at higher risk for severe illness than people in their 50s. The greatest risk for severe illness from COVID-19 is among those aged 85 or older.

“Eight out of 10 COVID-19-related deaths reported in the United States have been among adults aged 65 years and older.”

The CDC says those at increased risk of severe illness from COVID-19, and those who live with them, should consider their level of risk before deciding to go out.

“Consider avoiding activities where taking protective measures may be difficult, such as activities where social distancing can’t be maintained.

“In general, the more people you interact with, the more closely you interact with them, and the longer that interaction, the higher your risk of getting and spreading COVID-19.”

If you do go out, have a mask, a sanitiser made of at least 60 per cent alcohol and keep your distance from people not wearing masks.

Are you still concerned about going out in public in Australia, despite low levels of COVID-19?

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Written by Will Brodie

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