Doctors in London are launching a trial to determine if ibuprofen could treat serious cases of Covid-19 and save thousands of lives.
Experts hope that a special formula containing the inexpensive pain reliever will prevent the life-threatening respiratory problems that coronavirus patients may experience.
This could cause infected patients to spend less time in hospital and avoid being sent to intensive care or requiring ventilation.
Studies in animals with severe respiratory illness – which can be caused by Covid-19 – have shown that ibuprofen can increase survival rates by up to 300%.
The researchers said the results are “very promising” and that they “want to translate this truly convincing result in humans.”
There is controversy at the start of the pandemic over fears that anti-inflammatory drugs may worsen Covid-19 for those with mild symptoms.
The NHS has removed advice to remove ibuprofen for the coronavirus from its website amid concerns over the safety of the drug, which can be purchased for a few cents.
But a review of 13 scientific studies on the effects of anti-inflammatory drugs, such as ibuprofen, found no evidence for or against its use.
Doctors in London launch trial to see if ibuprofen could treat serious cases of Covid-19 and save lives
Now researchers from the same group who have suggested that ibuprofen is safe for Covid-19 – NHS Foundation Trust from Guy and St Thomas in London and King’s College London – are seeing if it can even help cure the disease .
The LIBERATE trial, which started in late May, is being conducted with the pharmaceutical organization SEEK Group.
The drug is a unique formulation of ibuprofen, the use of which is already authorized in the UK, but which is very different from what is available over the counter.
Half of the 230 hospital patients enrolled in the trial will receive standard care, which tends to give them more oxygen.
The other half will receive standard care along with the special formulation of ibuprofen, hoping to avoid aggressive treatment further.
Doctors will assess whether the medicine can reduce a serious side effect seen in infected patients called acute respiratory distress syndrome (ARDS).
WHY EXPERTS SAY THAT IBUPROFEN MAY Worsen CORONAVIRUS SYMPTOMS?
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). It works by blocking the production of certain natural substances that cause inflammation and is used to decrease pain or fever.
Scientists say there is no clear evidence that ibuprofen worsens COVID-19, but there were concerns that this was the case at the start of the pandemic. That is why:
Professor Paul Little, head of primary care research, University of Southampton, said: “There is now substantial literature from case-control studies in several countries that prolonged illness or complications of respiratory infections can be more common when NSAIDs are used. “
Experts say paracetamol should be a first choice because:
1. Ibuprofen can dampen the body’s immune response to infections because it has anti-inflammatory effects. This could slow the recovery process, said Professor Ian Jones, a virologist at the University of Reading.
2. He added that the coronavirus is likely to act similarly to SARS, in that it reduces an enzyme that regulates salt and water in the blood. This can lead to pneumonia. Ibuprofen could make this worse, said Professor Jones.
2. NSAIDs can cause stomach irritation and kidney stress if taken over a long period of time. This could be exacerbated in those who already have kidney or stomach problems caused by a serious illness, such as COVID-19, experts said.
ARDS – when the lungs become severely inflamed – can kill. Many sufferers are unable to breathe on their own and need to be ventilated.
If this can be avoided, it could mean that fewer patients end up on ventilation, which doctors prefer to avoid at all costs due to the potential long-term damage.
Mitul Mehta, professor of neuroimaging and psychopharmacology at Kings College London, said, “This is a trial for patients with Covid-19 disease to see if they are given an anti-inflammatory drug – a specific form of ‘ibuprofen – will reduce the breathing problems they have. ‘
He stressed that the trial was aimed at hospital patients – not those suffering from mild or suspected Covid-19.
Participants will be chosen from those who are hospitalized, but not so sick that they need intensive care.
Professor Mehta added, “And if we can reduce their symptoms at this point, we have a number of advantages: we could reduce the time someone spends in the hospital – they could recover faster and go home him, it is obviously a fantastic result; we could also reduce the level of respiratory distress so that it can be managed in a hospital setting, without the need for intensive care. And it’s also a fantastic result.
“Theoretically, this treatment, administered right now, should be beneficial.
“But of course, this is based on animal studies. This is based on case reports, we have to go to trial to show that the evidence really does match what we expect.
Professor Mehta said animal studies on acute respiratory distress syndrome – a complication of Covid-19 disease – show that around 80% of animals with this disease die.
But when given this special formulation of ibuprofen, survival rates increase to 80% – a four-fold improvement.
“It’s very promising,” he said. “But of course, this is an animal study, so we want to translate this really convincing result in humans. “
It is hoped that the way the drug was formulated will reduce the potential gastric side effects associated with ibuprofen.
Professor Matthew Hotopf, Director of the NIHR Maudsley Biomedical Research Center said: “This very innovative therapeutic approach aims to rapidly advance a potentially important new treatment.
“If successful, the global public health value of this trial result would be immense given the low cost and availability of this drug. “
Laboratory experiments by the SEEK group show that the drug was more effective than standard ibuprofen in treating ARDS.
At the start of the pandemic, there was controversy over the use of ibuprofen after a French health minister advised against its use.
French Minister of Health Olivier Véran, a doctor and qualified neurologist, expressed his concerns about anti-inflammatory drugs in a tweet on March 14.
He said, “Taking anti-inflammatory drugs may be an aggravating factor in the infection. If you have a fever, take paracetamol. “
A few days earlier, a letter published in The Lancet Respiratory Medicine suggested that ibuprofen could facilitate the entry of SARS-CoV-2 into cells.
At this point, the NHS recommendations for anyone self-isolating with symptoms of Covid-19 should take medication with paracetamol and ibuprofen.
Ibuprofen is widely used to relieve pain and reduce fever and pain caused by colds and flu.
Concerns prompted No. 10 chief science adviser Sir Patrick Vallance to say “the smart thing to do” is to not take ibuprofen until the science becomes clearer.
Scientists at King’s College London have launched a review to assess nonsteroidal anti-inflammatory drugs (NSAIDs) that affect the body’s immune system.
The team went through studies related to Covid-19 and published their review in the journal ecancermedicalscience.
The team wrote, “Our research has identified no solid evidence for or against the use of ibuprofen for the treatment of COVID-19 in particular.
“The current literature does not provide conclusive evidence for or against the use of NSAIDs in the treatment of patients with COVID-19.”
Cancer and transplant patients have a higher risk of developing serious complications from Covid-19, especially since they can be treated with drugs that stop their immune systems from working properly.
If these patients get the coronavirus, their doctors need to know which medications to stop giving them to prevent their illness from becoming serious.
The Expert Working Group of the Commission on Medicines for Human Use concluded: “There is currently insufficient evidence to establish a link between the use of ibuprofen and the susceptibility to contract or worsening of Covid-19 symptoms.