Which Drugs Are Being Used To Treat COVID-19? / Quali farmaci vengono utilizzati per trattare COVID-19?
Which Drugs Are Being Used To Treat COVID-19? / Quali farmaci vengono utilizzati per trattare COVID-19?
Segnalato dal Dott. Giuseppe Cotellessa / Reported by Dr. Giuseppe Cotellessa
With doctors and researchers around the world searching for effective treatments for COVID-19, many drugs approved to treat other diseases are being used in hopes that they’ll be effective against the virus, a use that’s known as “off-label.” New research from the Perelman School of Medicine at the University of Pennsylvania catalogued every use documented in medical literature so far and found physicians have reported on the use of more than 100 different off-label and experimental treatments. The effort, called COvid19 Registry of Off-label & New Agents (CORONA), is an attempt to take an inventory of what’s being used where, as well as to spot any evidence of treatments that warrant further investigation in a randomized clinical trial. The findings published in Infectious Diseases and Therapy today.
“We can’t win this fight if we don’t take stock of the tools that are already being used and search for new ones that could be effective. While off-label use is happening all over the world, there’s currently no system in place to track it, so we felt like we had to create one,” said the study’s lead author David C. Fajgenbaum, MD, MBA, MSc, an assistant professor of Translational Medicine & Human Genetics and director of the Center for Cytokine Storm Treatment & Laboratory (CSTL) at Penn.
Fajgenbaum is also the executive director of the Castleman Disease Collaborative Network (CDCN) and a Castleman patient himself. In 2012, after failing to respond to other therapies and having relapsed multiple times after chemo, Fajgenbaum’s research suggested a drug approved for other uses may be effective for his condition. Based on his own research and in consultation with his treating physician, Fajgenbaum decided to test the drug on himself and has been in remission ever since.
“With the world facing its greatest public health crisis in a century, we decided to take action, using the same approach that helped me and applying it to potentially help find promising leads in the treatment of COVID-19,” Fajgenbaum said.
The team reviewed about 2,700 published papers from all over the world detailing the treatment of COVID-19. From there, they gathered data on 9,152 patients and found doctors had tried 115 different drugs. These treatments were grouped into categories – antivirals were unsurprisingly the most common, followed by antibacterials and corticosteroids. The analysis also showed the use of immunosuppressants and blood substitutes, among other treatment options. Sheila Pierson, MS, the associate director for clinical research at the CSTL, director of registry enrollment for the CDCN, and the study’s senior author, led the analysis of the data.
“Our team has spent the last several years studying drugs used to control the cytokine storm in Castleman disease, so I’m glad we were able to apply these principles to COVID19. The work remains ongoing, and we are updating this drug inventory daily as we continue to compile information on other treatments as they’re being reported in the medical literature,” Pierson said.
Fajgenbaum notes that the goal of this work is not to point toward the most effective treatment, but to provide a resource for what may be candidates for further study.
“We hear a lot about the same handful of drugs, but we show here that there are many more currently in use than those that have already made headlines. Anything that shows promise anecdotally still needs to be rigorously tested in a clinical trial to see if it is effective and safe,” Fajgenbaum said.
“We can’t win this fight if we don’t take stock of the tools that are already being used and search for new ones that could be effective. While off-label use is happening all over the world, there’s currently no system in place to track it, so we felt like we had to create one,” said the study’s lead author David C. Fajgenbaum, MD, MBA, MSc, an assistant professor of Translational Medicine & Human Genetics and director of the Center for Cytokine Storm Treatment & Laboratory (CSTL) at Penn.
Fajgenbaum is also the executive director of the Castleman Disease Collaborative Network (CDCN) and a Castleman patient himself. In 2012, after failing to respond to other therapies and having relapsed multiple times after chemo, Fajgenbaum’s research suggested a drug approved for other uses may be effective for his condition. Based on his own research and in consultation with his treating physician, Fajgenbaum decided to test the drug on himself and has been in remission ever since.
“With the world facing its greatest public health crisis in a century, we decided to take action, using the same approach that helped me and applying it to potentially help find promising leads in the treatment of COVID-19,” Fajgenbaum said.
The team reviewed about 2,700 published papers from all over the world detailing the treatment of COVID-19. From there, they gathered data on 9,152 patients and found doctors had tried 115 different drugs. These treatments were grouped into categories – antivirals were unsurprisingly the most common, followed by antibacterials and corticosteroids. The analysis also showed the use of immunosuppressants and blood substitutes, among other treatment options. Sheila Pierson, MS, the associate director for clinical research at the CSTL, director of registry enrollment for the CDCN, and the study’s senior author, led the analysis of the data.
“Our team has spent the last several years studying drugs used to control the cytokine storm in Castleman disease, so I’m glad we were able to apply these principles to COVID19. The work remains ongoing, and we are updating this drug inventory daily as we continue to compile information on other treatments as they’re being reported in the medical literature,” Pierson said.
Fajgenbaum notes that the goal of this work is not to point toward the most effective treatment, but to provide a resource for what may be candidates for further study.
“We hear a lot about the same handful of drugs, but we show here that there are many more currently in use than those that have already made headlines. Anything that shows promise anecdotally still needs to be rigorously tested in a clinical trial to see if it is effective and safe,” Fajgenbaum said.
ITALIANO
Con i medici e i ricercatori di tutto il mondo che cercano trattamenti efficaci per COVID-19, molti farmaci approvati per il trattamento di altre malattie vengono utilizzati nella speranza che siano efficaci contro il virus, un uso noto come "off-label". Una nuova ricerca della Perelman School of Medicine dell'Università della Pennsylvania ha catalogato ogni uso finora documentato nella letteratura medica e ha scoperto che i medici hanno riferito sull'uso di oltre 100 diversi trattamenti off-label e sperimentali. Lo sforzo, chiamato COvid19 Registry of Off-label & New Agents (CORONA), è un tentativo di fare un inventario di ciò che viene utilizzato dove, nonché di individuare eventuali prove di trattamenti che giustificano ulteriori indagini in uno studio clinico randomizzato. I risultati pubblicati oggi in Malattie infettive e terapia.
"Non possiamo vincere questa lotta se non facciamo il punto sugli strumenti che sono già in uso e ne cerchiamo di nuovi che potrebbero essere efficaci. Mentre l'uso off-label sta avvenendo in tutto il mondo, al momento non esiste alcun sistema per rintracciarlo, quindi ci siamo sentiti come se dovessimo crearne uno ”, ha affermato l'autore principale dello studio David C. Fajgenbaum, MD, MBA, MSc, un assistente professore di Medicina traslazionale e genetica umana e direttore del Center for Cytokine Storm Treatment & Laboratory (CSTL) di Penn.
Fajgenbaum è anche direttore esecutivo della Castleman Disease Collaborative Network (CDCN) e un paziente Castleman stesso. Nel 2012, dopo aver fallito nel rispondere ad altre terapie ed essere ricaduto più volte dopo la chemio, la ricerca di Fajgenbaum ha suggerito che un farmaco approvato per altri usi potrebbe essere efficace per le sue condizioni. Sulla base delle sue ricerche e in consultazione con il suo medico curante, Fajgenbaum ha deciso di testare il farmaco su se stesso ed è in remissione da allora.
"Con il mondo che sta affrontando la sua più grande crisi di salute pubblica in un secolo, abbiamo deciso di agire, usando lo stesso approccio che mi ha aiutato e applicandolo per potenzialmente trovare contatti promettenti nel trattamento di COVID-19", ha detto Fajgenbaum.
Il gruppo ha esaminato circa 2.700 articoli pubblicati da tutto il mondo, descrivendo in dettaglio il trattamento di COVID-19. Da lì, hanno raccolto dati su 9.152 pazienti e hanno scoperto che i medici avevano provato 115 farmaci diversi. Questi trattamenti sono stati raggruppati in categorie: gli antivirali erano ovviamente i più comuni, seguiti da antibatterici e corticosteroidi. L'analisi ha anche mostrato l'uso di immunosoppressori e sostituti del sangue, tra le altre opzioni di trattamento. Sheila Pierson, MS, direttore associato per la ricerca clinica presso il CSTL, direttore delle iscrizioni al registro per il CDCN e autore senior dello studio, ha guidato l'analisi dei dati.
"Il nostro gruppo ha trascorso gli ultimi anni a studiare i farmaci usati per controllare la tempesta di citochine nella malattia di Castleman, quindi sono contento di essere stati in grado di applicare questi principi a COVID19. Il lavoro rimane in corso e stiamo aggiornando quotidianamente questo inventario dei farmaci mentre continuiamo a raccogliere informazioni su altri trattamenti come vengono riportati nella letteratura medica ", ha detto Pierson.
Fajgenbaum osserva che l'obiettivo di questo lavoro non è quello di indicare il trattamento più efficace, ma di fornire una risorsa per quelli che potrebbero essere candidati per ulteriori studi.
“Sentiamo molto parlare della stessa manciata di farmaci, ma mostriamo qui che ce ne sono molti altri attualmente in uso rispetto a quelli che hanno già fatto notizia. Tutto ciò che mostra promesse aneddotiche deve ancora essere rigorosamente testato in uno studio clinico per vedere se è efficace e sicuro ", ha detto Fajgenbaum.
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