Dupilumab, a monoclonal antibody that suppresses interleukin-13 can improve survival rates for patients with moderate to severe COVID, according to the results of a small clinical trial published in the Open Forum of Infectious Diseases.
Dupilumab is most often prescribed for skin conditions such as atopic dermatitis, asthma, and sinus congestion and swelling. The treatment also proved safe in the small study, as expected, because dupilumab is already a safe and effective allergy medicine.
The small trial, designed and led by Dr Jennifer Sasson, found that dupilumab improved patient survival at 60 days and reduced the number of patients who needed intensive care. Almost 90% of patients who received dupilumab in the randomised trial were alive at 60 days, compared with 76% of patients who did not.
“Our clinical trial suggests that treatment with the anti-allergy medicine dupilumab may decrease deaths due to COVID,” said Dr Sasson, of the University of Virginia School of Medicine. “A large multi-institution study to validate these preliminary results is being designed. If successful, this multi-site trial will open a new window to treatment of COVID and potentially other viral pneumonias.”
Cytokine levels inspire trial
The researchers were inspired to launch the trial after discovering that COVID patients were at significantly greater risk of needing a ventilator if their blood contained high levels of the cytokine interleukin-13. Dupilumab, which received FDA approval in 2017, works by blocking the effects of IL-13 and reducing inflammation.
To see if dupilumab could improve the body’s immune response to COVID, Sasson and her collaborators enrolled 40 patients with moderate to severe cases in a clinical trial. The trial was double-blinded, meaning neither the patients nor the doctors knew whether the patient was receiving the antibody or a placebo. Both groups of trial participants otherwise received standard care.
After 28 days, no difference was seen between the two groups in ventilator-free survival or in adverse events. But by 60 days, there were only two deaths among the patients receiving dupilumab and five deaths among those receiving placebo.
Among the patients who were not already in the intensive care unit when they joined the trial, three receiving dupilumab were ultimately admitted to the ICU, compared to six receiving placebo.
Source: University of Virginia
