Emilia vexler
08/08/2020 - 18:13
- Clarín.com
- Society
For confidentiality reasons, they cannot inform the Capital clinic where they are nebulizing people infected with the coronavirus with ibuprofen . But in these patients, the treating doctors already assure that the results are as encouraging as those reported in Córdoba and, this week, also in Jujuy.
Ibuprofen can be on the nightstand or in the glove compartment of many people's cars right now. In the offices -when you could still go-, with the slightest pain, the blisters are treated like candy. What's more, during menstruation women can take up to 400 mg of soft capsules twice a day. How is it that this common, accessible drug can curb deaths from the coronavirus pandemic with just a 50 mg dose at a time?
This is the story of ibuprofen therapy created by researchers from Cordoba and proposes that, thanks to nebulization, the drug acts like "soap" in the face of covid-19 .
Unlike plasma with recovered antibodies, behind this new treatment there is a hint of mystery.
“Plasma has a lot of press because it has been studied and applied by many teams around the world. But it also has unwanted effects. On the other hand, in this nebulizing therapy we have already shown that ibuprofen is totally safe . Against the covid it is also being used in Great Britain, but in swallowable tablets. Ibuprofen is a drug that we have known for 60 years and we must continue taking steps forward ", explains to Clarin Nestor García, the Conicet researcher who developed the project at the Center of Excellence in Products and Processes of Córdoba (Ceprocor), together with the Chemical Luar company.
This is a compassionate use treatment. The plasma is already a clinical trial. What separates one therapy from the other is the approval of the National Administration of Drugs, Food and Medical Technology (ANMAT), which remains undefined on ibuprofen .
On July 17, Química Luar, the laboratory that develops the ibuprofenate formula (strong in sodium and in a format suitable for nebulization), presented all the results and the protocol for the clinical trial. "I cannot answer for the delay of the ANMAT, but it should have resolved it in 15 days," says García, who is the main coordinator of the studies in these patients.
Still, in total, in the three districts it has already been tested on 104 people . The "scientific" sample, which has all the data to present to the ANMAT, is of 53 patients who overcame the virus after these nebulizations . They were 54, one died of "multiorgan failure", which is when lungs, liver and heart worsen.
So, for now, the ibuprofen therapy protocol must be approved by the bioethics committee of each health institution that wishes to apply it . While in a normal clinical trial reports are required every three or six months, in this case the provincial health authorities have the obligation to check the evolution of patients every seven days. It all started with the nebulisations of infected people in the San Roque Hospital in Córdoba, then in private clinics, then in the San Roque Hospital but in Jujuy and, recently, also in Buenos Aires.
Néstor García, the doctor behind the ibuprofen treatment that is already being tested in Buenos Aires against the coronavirus.
It is applied with a hood in the patient - to avoid the aerolization of the virus - twice a day, with a measure of 50 mg per nebulization. From Córdoba, the doctors who apply it are trained and the bell is sent to them, in addition to the nebulizing formulation. Everything is Argentine industry.
"This compassionate use gave positive results when used in the inflammatory phase of SARS-CoV-2. It kept patients from reaching the level of deterioration where they need mechanical ventilation (MRA) . We apply it to mild to moderate patients. , with comorbidities or without pre-existing diseases. It worked very well in severe hypoxia (lack of oxygen), in 48 hours they were already normal. Then there is the period of making sure that everything continues well. This is science, it is not the wish one could have . For that reason we must and we want to continue investigating, "Garcia details.
As he explains, the oxygen saturation of 100% of the treated patients was normal on the third day of treatment, and no patient nebulized for more than one day required MRA. That is why, like plasma, Luarprofen - the commercial name of the formulation - seeks to test its potential to reduce the use of respirators , the critical point to avoid the collapse of the health system.
Ibuprofen has many properties and also a bactericidal effect . But it is insoluble in water. In Córdoba they managed to make it so. That is ibuprofenate sodium. They created a hypertonic solution (with a high concentration of salt) that is inhaled in the form of a fine vapor and has been used since 2018 to nebulize patients with cystic fibrosis, in order to loosen their mucus, something desirable in those infected by coronavirus. Just as the drug inactivated the bacteria of this disease, they knew that it could also inactivate viruses. And Sars Cov-2, which causes the respiratory disease Covid-19, is a virus.
The goal was for nebulization to reduce the viral load in the airways of infected patients. That ibuprofen intercalates in the lipid membrane of the new coronavirus, inactivates it and prevents it from spreading.
A "colored" fact, says García, is that in Buenos Aires, due to the complications of the pandemic that delayed delivery and also due to the number of hospitalized patients who are being nebulized in the Metropolitan Area, they ran out of formulation with Ibuprofen. "They called us and said, 'Skinny, send me more Ibuprofen, which is working very well," he says.
The best known effect of ibuprofen is its anti-inflammatory power , and SARS-CoV-2 causes an inflation in the lungs that sometimes transforms into hyperinflammation and leads to the most severe cases. García assures that nebulizing enhances this effect of the drug, because it enters the lung in the presence of a high concentration of salt. According to the experience in tests of other researchers, ibuprofen would also control the mechanisms of entry of viruses into the cell, for example, in the case of Ebola, because it acts on actin, a protein that gives cells structure. All are experiments, it is worth clarifying, like the fogging of now against the covid-19.
Regarding the results of the treatment in Buenos Aires, from Química Luar they assure this newspaper that "the stories of the recovered patients will be released as soon as the clinic allows."
ACE