Could a Long-Used Cholesterol Drug Fight Severe COVID-19?
A drug that lowers cholesterol might help save hospitalized patients with COVID-19, a new, small Israeli study suggests.
Researchers at Hebrew University of Jerusalem noted that COVID causes a big buildup of cholesterol, which results in inflammation in cells.
In lab experiments, they found that the cholesterol-lowering drug fenofibrate (TriCor) effectively reduced damage to lung cells and stopped the SARS-CoV-2 virus from replicating. A study in 15 patients confirmed the lab results.
"They've shown that fenofibrate can potentially reduce the chance of a patient becoming hospitalized, it can decrease the amount of time they spend in hospital, decrease their need for oxygen, and it might even decrease the risk of dying, so I'm cautiously optimistic, but these are very small numbers of patients, so I am cautious," said Alan Richardson, a reader in pharmacology at Keele University in Staffordshire, U.K., who reviewed the findings.
He said the drug appears to work by affecting the metabolic changes that happen when the SARS-CoV-2 virus invades cells.
In his own research, Richardson found that TriCor could potentially stop the virus from getting inside the cells in the first place.
But he strongly emphasized that people should not take TriCor in hopes of preventing COVID-19 infection.
"I'd strongly advise people not to do it on their own without talking to a doctor," he said.
In this new trial, researchers gave TriCor to 15 patients hospitalized with severe COVID-19. All had pneumonia and required oxygen. They were given TriCor for 10 days.
Study leader Dr. Yaakov Nahmias said the results were "astounding."
"Progressive inflammation markers, [which] are the hallmark of deteriorative COVID-19, dropped within 48 hours of treatment," Nahmias said in a news release. "Moreover, 14 of the 15 severe patients didn't require oxygen support within a week of treatment, while historical records show that the vast majority [of] severe patients treated with the standard of care require lengthy respiratory support."
A biomedical engineer at Hebrew University, Nahmias is also a faculty member at Harvard University's Center for Engineering in Medicine in Boston.
"There are no silver bullets, but fenofibrate is far safer than other drugs proposed to date," he said, adding that the way it works makes it less likely to be effective only with specific coronavirus variants.
All 15 patients left the hospital in less than a week and had no side effects from the drug, according to the study. Few reported COVID side effects during four weeks of follow-up.
Although the results were promising, researchers said only larger trials can prove the drug's effectiveness as a COVID treatment.
Two phase 3 trials are underway in South America and the United States, according to the researchers.
Dr. Marc Siegel, a professor of medicine at NYU Langone Medical Center in New York City, reacted with caution to the findings.
"This is just an observational study with 15 people, so it's way too early to be saying that this medicine should be used," he said, adding that he's not sure that in the long run TriCor will be the medication of choice for COVID patients.
"We've gotten magic bullets in the works in the lab," Siegel said. "We're going to have an antiviral for COVID-19, but I don't think it's going to be this."
He said further study is warranted, however.
"Maybe TriCor will have some impact, but we're getting much closer to true antiviral treatments that may be game-changers," he said.
Siegel emphasized that TriCor doesn't take the place of COVID-19 vaccines in fighting the virus.
"Nothing takes the place of a vaccine, nothing," he stressed.
The study was published online Aug. 23 on the preprint server Research Square, but the findings have not yet been peer-reviewed.
For more on COVID-19, head to the U.S. Centers for Disease Control and Prevention.
SOURCES: Alan Richardson, PhD, reader in pharmacology, Keele University, Staffordshire, U.K.; Marc Siegel, MD, clinical professor, medicine, NYU Langone Medical Center, New York City; Hebrew University of Jerusalem, news release, Aug. 23, 2021; Research Square, online, Aug. 23, 2021