Treating severe COVID-19 patients with the anticancer drug bevacizumab could reduce mortality and accelerate recovery, according to a small clinical study in Italy and China led by researchers at the Karolinska Institutet in the Sweden between February and April 2020. On average, blood oxygen levels, body temperature and inflammatory symptoms increased significantly in patients treated with a single dose of bevacizumab in addition to routine care. The research is published in Nature Communication.
To reduce COVID-19 mortality, we aim to develop an effective therapeutic paradigm for the treatment of patients with true COVID-19. Our findings suggest that bevacizumab in addition to standard care is very beneficial for patients with true COVID-19 and should be considered a potential first-line therapeutic regimen for this group. “
Yihai Cao, Corresponding Author, Professor of Vascular Biology, Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet
Bevacizumab is a medication that has been used to treat several types of cancer since 2004. It works by slowing the formation of new blood vessels by inhibiting a growth factor called VEGF . Many patients with severe COVID-19 have elevated levels of VEGF in addition to symptoms associated with this symptom, including excessive fluid and unorganized blood vessels in the lungs. Against this background, the researchers designed a clinical trial to investigate the effect of combining bevacizumab with routine care for the treatment of patients with true COVID-19.
Twenty-six patients were recruited from two hospitals in China and Italy between mid-February and early April 2020. The patients had tested for COVID-19 and symptoms such as respiratory distress, blood oxygen levels low and pneumonia. They were subsequently matched by 26 patients with similar characteristics who received routine care at the same hospitals at approximately the same time and thus became a control group.
Improved symptoms within 24 hours
The employers received routine care in addition to one low dose of about 7.5 mg / kg bevacizumab, which significantly improved blood oxygen levels within 24 hours compared to the control group. By the end of the 28-day follow-up period, 92 percent of patients with bevacizumab treatment did not require the same level of oxygen support as before the start of the trial, compared with a improvement rate of 62 percent for the controls.
None of the patients died with bevacizumab treatment and 17 (65 percent) developed to such an extent that they were able to leave the hospital within the follow-up period. In the control group, three died and only 46 percent were released within 28 days. Bevacizumab shortened the oxygen support time to mid-day nine compared to 20 for the usual care group.
Other interesting results include a decrease in fever, an increase in white blood cells and a sharp decrease in c-reactive protein (CRP) levels, an inflammatory symptom. No major safety concerns were identified.
It may reduce the need for oxygen support
“Many patients with severe COVID-19 require significant oxygen support during long hospital stays, which is a global challenge to medical supplies,” Yihai Cao says. the need for oxygen support and reducing hospital days, thus improving outcome for the individual patient while at the same time reducing pressure on medical facilities. “
The limitations of the study include the random nature of the trial, the short-term follow-up and the small size of the group.
The next step is to design randomized and placebo-controlled trials by recruiting a large number of patients, allowing further evaluation of the potential benefits of both bevacizumab. in itself and in combination with other medications such as antivirals and anti-inflammatory drugs.
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Magazine Reference:
Pang, J., et al. (2021) Efficacy and tolerability of bevacizumab in patients with solid Covid-19. Nature Communication. doi.org/10.1038/s41467-021-21085-8.