Safety and efficacy of artemisinin-piperaquine for treatment of COVID-19: an open-label, non-randomised and controlled trial

Li, Guoming; Mei, Yi; Li, Haihong; Deng, Changsheng; Wang, Qi; Tang, Yexiao; Zhang, Hongying; Yu, Weisheng; Xu, Qin; Zou, Yuanyuan; Yuan, Yueming; Guo, Jiawen; Jin, Chunming; Guan, Xiangdong; Xie, Fengjie; Shen, Jianping

doi:10.1016/j.ijantimicag.2020.106216

Cited by 48 publications

(48 citation statements)

References 32 publications

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“…Artemisinin and its antimalarial properties were discovered by the Chinese scientist Tu Youyu, who became one of the laureates of the 2015 Nobel Prize in Physiology or Medicine for this discovery (12). Artemisinin and Artemisinin derivatives are generally well-tolerated, especially when used for a short treatment course (10, 12, 18-24). Except for the rare occurrence of hepatotoxicity and mild-moderate headache, nausea, vomiting, fatigue, and anorexia, Artemisinin was found to be clinically safe in healthy volunteers as well as malaria patients (10, 12, 18-24).…”

Section: Discussionmentioning

confidence: 99%

“…Consequently, Artemisinin has recently been repurposed as a potential COVID-19 drug (12). Li et al reported the results from an open-label non-randomized study in which 41 COVID-19 patients received either standard of care (SOC) therapy (control) or SOC combined with Artemisinin plus piperaquine (AP) (18). Patients in the AP group showed a faster clearance of SARS-CoV-2 than control patients.…”

Section: Introductionmentioning

confidence: 99%

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Targeting TGF-β pathway with COVID-19 Drug Candidate ARTIVeda/PulmoHeal Accelerates Recovery from Mild-Moderate COVID-19

Trieu¹,

Saund²,

Barge

et al. 2021

Preprint

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Our COVID-19 drug candidate ARTIVeda™/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 ARTIVeda™ in adult COVID-19 patients with symptomatic mild-moderate COVID-19, who were treated in a randomized, open-label Phase IV 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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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Targeting TGF-β pathway with COVID-19 Drug Candidate ARTIVeda/PulmoHeal Accelerates Recovery from Mild-Moderate COVID-19

Trieu¹,

Saund²,

Barge

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…In a small 41-person study, ACTs were shown to be therapeutic in SARS-CoV-2-positive patients. 61 The administration of artemisinin-piperaquine (ART-PQP) reduced viral titers to undetectable levels in all 23 patients by day 21, whereas patients that did not receive ART-PQP treatment only cleared virus at day 36. 61 A major caveat of this study is that patients in each group also received multiple other treatments, including interferon α-1b, HCQ, ribavirin, oseltamivir, lopinavir, and other herbal remedies.…”

Section: Artemisininsmentioning

confidence: 99%

“… 61 A major caveat of this study is that patients in each group also received multiple other treatments, including interferon α-1b, HCQ, ribavirin, oseltamivir, lopinavir, and other herbal remedies. 61 …”

Section: Artemisininsmentioning

confidence: 99%

Repurposing Quinoline and Artemisinin Antimalarials as Therapeutics for SARS-CoV-2: Rationale and Implications

Firestone

Oyewole

Reid

et al. 2021

ACS Pharmacol. Transl. Sci.

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The coronavirus disease-2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has infected more than 116 million individuals globally and resulted in over 2.5 million deaths since the first report in December 2019. For most of this time, healthcare professionals have had few tools at their disposal. In December 2020, several vaccines that were shown to be highly effective have been granted emergency use authorization (EUA). Despite these remarkable breakthroughs, challenges include vaccine roll-out and implementation, in addition to deeply entrenched antivaccination viewpoints. While vaccines will prevent disease occurrence, infected individuals still need treatment options, and repurposing drugs circumvents the lengthy and costly process of drug development. SARS-CoV-2, like many other enveloped viruses, require the action of host proteases for entry. In addition, this novel virus employs a unique method of cell exit of deacidified lysosomes and exocytosis. Thus, inhibitors of lysosomes or other players in this pathway are good candidates to target SARS-CoV-2. Chemical compounds in the quinoline class are known to be lysomotropic and perturb pH levels. A large number of quinolines are FDA-approved for treatment of inflammatory diseases and antimalarials. Artemisinins are another class of drugs that have been demonstrated to be safe for use in humans and are widely utilized as antimalarials. In this Review, we discuss the use of antimalarial drugs in the class of quinolines and artemisinins, which have been shown to be effective against SARS-CoV-2 in vitro and in vivo , and provide a rationale in employing quinolines as treatment of SARS-CoV-2 in clinical settings.

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“…These observations suggest that SAMs may be suitable for repurposing during the current pandemic. 58 , 59 , 60 …”

Section: Repurposing Of Dermatologic Medications To Treat Covid-19mentioning

confidence: 99%

Drug repurposing of dermatologic medications to treat coronavirus disease 2019: Science or fiction?

Mateeva

Drenovska

2021

Clinics in Dermatology

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No pharmaceutical products have been demonstrated to be safe and effective to specifically treat coronavirus disease 2019 (COVID-19); therefore, the therapy administered to infected patients remains symptomatic and empiric. Alongside the development of new, often high-cost drugs, a different tactic is being applied in parallel, investigating long-established, inexpensive medications originally designed for a variety of diseases to study their potential in treating COVID-19. The skin is the largest organ of the human body. With more than 3,000 skin conditions identified, the specialty of dermatology offers a rich armamentarium of systemic therapeutic agents aimed to treat the various chronic immunologically mediated, metabolic, infectious, occupational, inherited, or paraneoplastic dermatoses. Dermatologists have extensive experience with many drugs that have demonstrated promising in vitro antiviral action (directly targeting the viral replication). Many of these drugs have been used as nonspecific immunosuppressive strategies, such as glucocorticoids, synthetic antimalarials, colchicine, or other immunomodulators, and a number of targeted therapeutics have been directed at controlling hyperinflammatory processes similar to the “cytokine storm” associated with COVID-19 infection. We discuss several dermatologic drugs that have already been used or may have a promising role in the treatment of COVID-19.

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Safety and efficacy of artemisinin-piperaquine for treatment of COVID-19: an open-label, non-randomised and controlled trial

Abstract: Highlights A new option therapy for COVID-19. Arteminsinin-Piperaquine, as the fourth-generation artemisinin-based combination therapy, have a therapeutic effect on COVID-19. Arteminsinin-Piperaquine treatment can significantly shorten the time to reach undetectable SARS-CoV-2.

Cited by 48 publications

References 32 publications

Targeting TGF-β pathway with COVID-19 Drug Candidate ARTIVeda/PulmoHeal Accelerates Recovery from Mild-Moderate COVID-19

Targeting TGF-β pathway with COVID-19 Drug Candidate ARTIVeda/PulmoHeal Accelerates Recovery from Mild-Moderate COVID-19

Repurposing Quinoline and Artemisinin Antimalarials as Therapeutics for SARS-CoV-2: Rationale and Implications

Drug repurposing of dermatologic medications to treat coronavirus disease 2019: Science or fiction?

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