March 30, 2020

Science Daily/King's College London

A recent study has found that there is no evidence for or against the use of non-steroidal anti-inflammatory drugs such as ibuprofen for patients with COVID-19.

The study, led by researchers at King's College London, also found other types of drugs, such as TNF blockers and JAK inhibitors safe to use.

89 existing studies on other coronavirus strains such as MERS and SARS, as well as the limited literature on COVID-19, were analysed to find out if certain pain medications, steroids, and other drugs used in people already suffering from diseases should be avoided if they catch COVID-19.

Some patients, for example those with cancer, are already given immunosuppressive drugs -- therapies that can lower the body's immune system -- or immunostimulant drugs -- therapies that boost it. If these patients then catch COVID-19, doctors need to know what medication to stop.

Dr Mieke Van Hemelrijck, a cancer epidemiologist and an author on the paper, said "This pandemic has led to challenging decision-making about the treatment of COVID-19 patients who were already critically unwell. In parallel, doctors across multiple specialties are making clinical decisions about the appropriate continuation of treatments for patients with chronic illnesses requiring immune suppressive medication."

The article has been published in ecancermedicalscience, an open access oncology journal, and is authored by researchers from King's College London and Guy's and St. Thomas NHS Foundation Trust, London.

There had been some speculation that non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen might make things worse for some COVID-19 patients, but the researchers did not find evidence to support this statement.

Other types of drugs such as TNF blockers and JAK inhibitors, used to treat arthritis or other forms of inflammation, were also found to be safe to use. Another class of drug known as anti-interleukin-6 agents is being investigated for helping to fight COVID-19, although there is no conclusive proof yet.

The researchers found that low amounts of prednisolone or tacrolimus therapy may be helpful in treating COVID-19. Co- author, Dr Sophie Papa, a medical oncologist and immunologist said: "Current evidence suggests that low dose prednisolone (a steroid used to treat allergies) and tacrolimus therapy (an immunosuppressive drug given to patients who have had an organ transplant) may have beneficial impact on the course of coronavirus infections. However further investigation is needed."

As more people catch the disease, researchers will continue to investigate how it interacts with commonly used medications and make further guidance recommendations.

https://www.sciencedaily.com/releases/2020/03/200330152143.htm