靶向tgf - β通路的COVID-19候选药物ARTIVeda/PulmoHeal加速轻中度COVID-19的恢复

V. Trieu, Saran Saund, P. Rahate, Viljay B. Barge, K. Nalk, H. Windlass, F. Uckun
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摘要

我们的COVID-19候选药物ARTIVedaTM/PulmoHeal是一种新型明胶胶囊配方,由青蒿提取物阿育吠陀(Ayurveda)制成,用于口服TGF-β靶向抗疟疾植物药物青蒿素,具有抗炎和抗sars - cov -2活性。在这里,我们报告了ARTIVedaTM在印度卡纳塔克邦班加罗尔的一项随机、开放标签的4期研究中治疗的有症状的成人COVID-19患者的安全性和有效性(印度临床试验注册中心标识号:CTRI/2020/09/028044)。ARTIVeda显示出非常有利的安全性,唯一与ARTIVeda相关的不良事件是短暂的轻度皮疹和轻度高血压。值得注意的是,当ARTIVeda加入到SOC中时,可以加速轻中度COVID-19患者的康复。虽然所有患者在基线时均有症状(WHO评分=2-4),但在接受ARTIVeda + SOC治疗的39例患者中,有31例(79.5%)在5天治疗结束时无症状(WHO评分=1),包括10例严重干咳患者中的10例,7例严重发热患者中的7例。相比之下,单独使用SOC治疗的21例对照患者中有12例(57.1%)在第5天无症状(p=0.028, Fisher精确检验)。当比较单独使用SOC与SOC加ARTIVeda治疗的住院COVID-19患者(WHO评分=4)的治疗结果时,这种临床获益尤其明显。SOC加ARTIVeda组(N=18)到无症状的中位时间仅为5天,而SOC单独组(N=10)的中位时间为14天(p=0.004, Log-rank检验)。这些数据为ARTIVeda靶向TGF-β通路的概念提供了临床证明,如果在病程早期给药,可能有助于轻中度COVID-19患者更快康复。
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Targeting TGF-beta pathway with COVID-19 Drug Candidate ARTIVeda/PulmoHeal Accelerates Recovery from Mild-Moderate COVID-19
Our COVID-19 drug candidate ARTIVedaTM/PulmoHeal is a novel gelatin capsule formulation of the Artemisia extract Ayurveda for oral delivery of TGF-β targeting anti-malaria phytomedicine Artemisinin with documented anti-inflammatory and anti-SARS-CoV-2 activity. Here we report the safety and efficacy of ARTIVedaTM in adult COVID-19 patients with symptomatic mild-moderate COVID-19, who were treated in a randomized, open-label Phase 4 study in Bangalore, Karnataka, India (Clinical Trials Registry India identifier: CTRI/2020/09/028044). ARTIVeda showed a very favorable safety profile, and the only ARTIVeda-related adverse events were transient mild rash and mild hypertension. Notably, ARTIVeda, when added to the SOC, accelerated the recovery of patients with mild-moderate COVID-19. While all patients were symptomatic at baseline (WHO score=2-4), 31 of 39 (79.5%) of patients treated with ARTIVeda plus SOC became asymptomatic (WHO score=1) by the end of the 5-day therapy, including 10 of 10 patients with severe dry cough 7 of 7 patients with severe fever. By comparison, 12 of 21 control patients (57.1%) treated with SOC alone became asymptomatic on day 5 (p=0.028, Fisher’s exact test). This clinical benefit was particularly evident when the treatment outcomes of hospitalized COVID-19 patients (WHO score=4) treated with SOC alone versus SOC plus ARTIVeda were compared. The median time to becoming asymptomatic was only 5 days for the SOC plus ARTIVeda group (N=18) but 14 days for the SOC alone group (N=10) (p=0.004, Log-rank test). These data provide clinical proof of concept that targeting the TGF-β pathway with ARTIVeda may contribute to a faster recovery of patients with mild-moderate COVID-19 when administered early in the course of their disease.
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