tetano
Editor, Senior Moderator
Virol Sin
. 2020 Jul 21.
doi: 10.1007/s12250-020-00258-7. Online ahead of print.
A Small-Scale Medication of Leflunomide as a Treatment of COVID-19 in an Open-Label Blank-Controlled Clinical Trial
Ke Hu[SUP] 1 [/SUP], Mengmei Wang[SUP] 2 [/SUP], Yang Zhao[SUP] 2 [/SUP], Yunting Zhang[SUP] 2 [/SUP], Tao Wang[SUP] 2 [/SUP], Zhishui Zheng[SUP] 2 [/SUP], Xiaochen Li[SUP] 2 [/SUP], Shaolin Zeng[SUP] 2 [/SUP], Dong Zhao[SUP] 2 [/SUP], Honglin Li[SUP] 3 [/SUP], Ke Xu[SUP] 4 [/SUP], Ke Lan[SUP] 5 6 [/SUP]
Affiliations
Abstract
We recently reported that inhibitors against human dihydroorotate dehydrogenase (DHODH) have broad-spectrum antiviral activities including their inhibitory efficacies on SARS-CoV-2 replication in infected cells. However, there are limited data from clinical studies to prove the application of DHODH inhibitors in Coronavirus disease 2019 (COVID-19) patients. In the present study, we evaluated Leflunomide, an approved DHODH inhibitor widely used as a modest immune regulator to treat autoimmune diseases, in treating COVID-19 disease with a small-scale of patients. Cases of 10 laboratory-confirmed COVID-19 patients of moderate type with obvious opacity in the lung were included. Five of the patients were treated with Leflunomide, and another five were treated as blank controls without a placebo. All the patients accepted standard supportive treatment for COVID-19. The patients given Leflunomide had a shorter viral shedding time (median of 5 days) than the controls (median of 11 days, P = 0.046). The patients given Leflunomide also showed a significant reduction in C-reactive protein levels, indicating that immunopathological inflammation was well controlled. No obvious adverse effects were observed in Leflunomide-treated patients, and they all discharged from the hospital faster than controls. This preliminary study on a small-scale compassionate use of Leflunomide provides clues for further understanding of Leflunomide as a potential antiviral drug against COVID-19.
Keywords: Coronavirus disease 2019 (COVID-19); DHODH inhibitors; Inflammation; Leflunomide; Viral shedding time.
. 2020 Jul 21.
doi: 10.1007/s12250-020-00258-7. Online ahead of print.
A Small-Scale Medication of Leflunomide as a Treatment of COVID-19 in an Open-Label Blank-Controlled Clinical Trial
Ke Hu[SUP] 1 [/SUP], Mengmei Wang[SUP] 2 [/SUP], Yang Zhao[SUP] 2 [/SUP], Yunting Zhang[SUP] 2 [/SUP], Tao Wang[SUP] 2 [/SUP], Zhishui Zheng[SUP] 2 [/SUP], Xiaochen Li[SUP] 2 [/SUP], Shaolin Zeng[SUP] 2 [/SUP], Dong Zhao[SUP] 2 [/SUP], Honglin Li[SUP] 3 [/SUP], Ke Xu[SUP] 4 [/SUP], Ke Lan[SUP] 5 6 [/SUP]
Affiliations
- PMID: 32696396
- DOI: 10.1007/s12250-020-00258-7
Abstract
We recently reported that inhibitors against human dihydroorotate dehydrogenase (DHODH) have broad-spectrum antiviral activities including their inhibitory efficacies on SARS-CoV-2 replication in infected cells. However, there are limited data from clinical studies to prove the application of DHODH inhibitors in Coronavirus disease 2019 (COVID-19) patients. In the present study, we evaluated Leflunomide, an approved DHODH inhibitor widely used as a modest immune regulator to treat autoimmune diseases, in treating COVID-19 disease with a small-scale of patients. Cases of 10 laboratory-confirmed COVID-19 patients of moderate type with obvious opacity in the lung were included. Five of the patients were treated with Leflunomide, and another five were treated as blank controls without a placebo. All the patients accepted standard supportive treatment for COVID-19. The patients given Leflunomide had a shorter viral shedding time (median of 5 days) than the controls (median of 11 days, P = 0.046). The patients given Leflunomide also showed a significant reduction in C-reactive protein levels, indicating that immunopathological inflammation was well controlled. No obvious adverse effects were observed in Leflunomide-treated patients, and they all discharged from the hospital faster than controls. This preliminary study on a small-scale compassionate use of Leflunomide provides clues for further understanding of Leflunomide as a potential antiviral drug against COVID-19.
Keywords: Coronavirus disease 2019 (COVID-19); DHODH inhibitors; Inflammation; Leflunomide; Viral shedding time.