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Inflammation levels 'fell like a rock'

$1.50-a-day lipid-lowering drug helps COVID patients in small Israeli trial

14 out of 15 patients were removed from oxygen in a week after taking fenofibrate, America’s 73rd most prescribed medicine; none experienced cytokine storm

Nathan Jeffay is The Times of Israel's health and science correspondent

Medical staff at the Barzilai hospital, in the southern Israeli city of Ashkelon, wear protective gear, as they handle a coronavirus test sample on March 29, 2020. (Flash90)
Medical staff at the Barzilai hospital, in the southern Israeli city of Ashkelon, wear protective gear, as they handle a coronavirus test sample on March 29, 2020. (Flash90)

A $1.50-a-day generic drug appears to have strong COVID-fighting ability, Israeli researchers say, after inflammation levels “fell like a rock” among coronavirus patients in a small clinical trial.

A research team from Hebrew University of Jerusalem proposed early in the pandemic that fenofibrate, a generic fat-lowering medication and one of America’s most prescribed medicines, could help COVID-19 patients.

It saw the drug effectively fight the coronavirus in-vitro a year ago, and has conducted data studies since. Now, the team has given the drug to 15 serious COVID-19 patients at Barzilai Medical Center in Ashkelon. All were receiving oxygen, yet all were discharged during the course of the 10-day trial.

“We saw that it works,” Prof. Yaakov Nahmias of the Hebrew University of Jerusalem told The Times of Israel. “This is very promising, and it’s exciting as this is a very cheap generic drug with minimal side effects.”

He stressed that further research involving a placebo group is getting underway, and is needed to draw firm conclusions, but said there is clear comparison data for the 15 patients, in the form of medical records from 144 others who were similarly sick with the coronavirus.

Based on these records, he expected just 28.5% of patients to come off oxygen in under seven days. He found that 93% — all but one patient — in his trial came off oxygen in this timeframe.

Illustration of data from the Hebrew University Fenofibrate study, showing when oxygen was safely withdrawn from patients (courtesy of. the Hebrew University)

The comparison data suggested that 80% to 90% of patients would experience a cytokine storm, the immune overreaction which often causes COVID deterioration. None of the 15 patients in the new study had an observable cytokine storm.

“We monitored patients very closely, taking samples every two days, and we tracked inflammation, which dropped like a rock, and immune responses,” said Nahmias. “Both gave cause for optimism.”

Medical staff in the Coronavirus ward of the Herzog Medical Center in Jerusalem, on July 29, 2021. (Yonatan Sindel/Flash90)

In June 2020 Nahmias, director of Hebrew University’s Grass Center for Bioengineering, announced that experiments in his lab indicated that fenofibrate could help coronavirus patients. In December, he reported that people who take fenofibrate for its lipid-lowering qualities have “astounding” outcomes compared to others with the coronavirus.

The medicine, which is sold under a number of brand names, is America’s 73rd most prescribed drug. It is designed to reduce lipids known as triglycerides, the most common type of fat.

When originally suggesting the drug, Nahmias’ team hypothesized that the novel coronavirus is so vicious because it causes lipids to be deposited in the lungs, and that fenofibrate could break down the lipids and help patients.

Prof. Yaakov Nahmias of the Hebrew University of Jerusalem (courtesy of the Hebrew University of Jerusalem)

Abbott Laboratories, one of several manufacturers of fenofibrate, provided a grant to support the research, but Nahmias stressed that the study, which has been published online but not yet peer reviewed, was independent. The trial was conducted before the Delta variant arrived in Israel, but Nahmias voiced confidence that the drug would work on different variants.

Prof. Shlomo Maayan, head of the Infectious Diseases Unit at Barzilai, coordinated the trial.

“This is significant,” he told The Times of Israel.

“It’s notable that all patients went home and and inflammatory markers were significantly reduced. Though we didn’t do a double blind controlled trial we did a historical control, meaning a comparison to a similar group of patients. And those patients were released later, their recovery rate was slower and the inflammatory markers didn’t go down so quickly as those in our study group.”

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