A new form of medication for COVID-19 has been developed by a British drug company. It is an inhalable drug that could reduce the risk of severe symptoms.
The inhalable COVID-19 medication was developed and tested by Synairgen, a company founded by the University of Southampton professors. It has been based on interferon beta and formulated to limit serious side effects. Via inhalation administration route, the drug would directly target cells located in the lungs. Test results showed that it decreased the risk of serious symptoms, improved recovery rate, and reduced untimely death of patients. The company published its preliminary findings in a press release.
What is Interferon Beta?
During an infection, the immune system relies on chemical signals released by affected cells and first responders. These signals allow the mobilization of innate immunity, and later on, adaptive immunity in case the situation escalates. The signals usually induce inflammation to enhance the permeability of blood vessel walls. This enables fighters to move quickly to the site of infection and contain it as fast as possible.
According to Sino Biological, a global manufacturer of reagents, one of these signals is a specialized protein called interferon. Upon its discovery, scientists managed to identify many types of interferon and their related functions. The interferon beta is an antiviral cytokine that activates numerous processes associated with immunity. Although it can also be triggered by bacterial infections, the cytokine is usually preferred against viral infections due to negative effects on the host.
So, when a person contracted influenza, their body is likely to produce interferon beta to wake up immune responses against viruses. It explains the symptoms a person can experience. Unfortunately, the SARS-CoV-2 virus has natural means to shut down the interferon response of the human body. The novel coronavirus is equipped with capabilities to stop nearby cells from alerting others of a viral infection. As such, supplementing a COVID-19 patient with interferon may prevent serious symptoms to occur.
However, the synthetic variant of the chemical is typically administered by injection. This is where the challenge comes in. Injecting interferon beta can cause systemic effects, which are not helpful for someone with COVID-19. The side effects may further decline the patient’s health. It makes it difficult for doctors to decide.
Inhalation Route for Interferon Beta
At Synairgen, the traditional route of administration of interferon beta is unlikely to work for COVID-19 patients. To make it viable, they developed a medication that could be administered through inhalation. The route would direct interferon beta to cells within the lungs and restrict systemic effects. The novel inhalable COVID-19 medication has been called SNG001 in a successful clinical trial. Preliminary findings showed promise in reducing severe symptoms.
"We are all delighted with the trial results announced today, which showed that SNG001 greatly reduced the number of hospitalized COVID-19 patients who progressed from ‘requiring oxygen’ to ‘requiring ventilation’. It also showed that patients who received SNG001 were at least twice as likely to recover to the point where their everyday activities were not compromised through having been infected by SARS-CoV-2,” said Richard Marsden, CEO of Synairgen.
In the double-blind, placebo-controlled trial, a total of 101 patients were recruited from nine specialist hospitals in the UK, from March 30 to May 27, 2020. The patients were assigned to either subject or control group. The assessment of the patients revealed an evenly matched average age of 56.6 years among subjects and 57.8 years among controls. While the average COVID-19 symptom duration and comorbidities were 9.6 days among subjects and 9.8 days among controls. Subjects were given SNG001 and controls were given placebos.
Results from the trial revealed that severe COVID-19 symptoms were reduced by 79% among subjects. Subjects were found with over two times the chance of recovery than controls. The chance of recovery referenced “no limitation of activities” or “no clinical or virological evidence of infection.” In terms of mortality, no subject died but three controls died during the treatment period.
Even though the difference in hospital discharge time was not statistically significant, findings highlighted that the average discharge time of subjects was six days, shorter than the nine days average discharge time of controls. And at the end of the treatment period, subjects appeared to be twice more likely to recover from COVID-19.
The findings of the clinical trial might be a breakthrough in COVID-19 treatments. But some scientists seemed doubtful of the drug’s efficacy across all settings. First, the trial had a small sample size of only 101. That size alone could not accurately differentiate drug benefits among all patients, including children, older people, and individuals with chronic illnesses. Second, the small sample size could not prove or disprove the marginal efficacy of the drug. It might work differently in certain population groups but works effectively in others. And third, the inhalation route of interferon beta was neither widely applied nor licensed for clinical settings. No solid evidence yet has shown that inhalation would not lead to systemic effects.
“If there is the material to distribute it to the population, and you could keep the price down, this could absolutely be a game-changer. I don’t doubt it will work. I just don’t know how feasible it is,” said Benjamin tenOever, a professor of microbiology at the Icahn School of Medicine at Mount Sinai, and was not part of the trial, quoted American newspaper The New York Times.
The use of non-injectable interferon has been explored before by various researchers worldwide. In China, a trial of the nasal drop version was tested and found to prevent COVID-19 infections among healthcare workers. That trial concluded with promising results in protecting healthy individuals, who might be prone to the disease. Even in the US and the UK, researchers were studying interferon use but faced difficulties in patient recruitment since caseloads dropped.
If the inhalable interferon medication works, it has to be commercially released at a reasonable price. Such a drug can protect medical workers, reduce the number of new cases in hospitals, and help end this pandemic.