12 February 2020
Could baricitinib help treat coronavirus?
UK researchers have rushed to publish a letter in The Lancet suggesting that the JAK inhibitor baricitinib (olumiant) could be helpful for treating coronavirus.
Justin Stebbing, a professor of cancer medicine and oncology at Imperial College London, and his colleges at BenevolentAI, a UK artificial intelligence company, created a “knowledge graph” to pinpoint which drugs might block the viral infection process.
They reasoned that most viruses enter cells through receptor-mediated endocytosis, and that by disrupting that process, they could reduce the ability of the virus to infect lung cells.
Specifically, the researchers were looking for a drug that could disrupt AAK1, a known regulator of endocytosis.
They identified 278 AAK1 inhibitors, 47 of which had been approved for medicinal use and six of which inhibited AAK1 with high affinity.
Some of these drugs were used in oncology and were inappropriate for respiratory disease because they had serious side effects, but baricitinib could be trialled in patients, the researchers said.
The researchers said the events in relation to the outbreak were “evolving rapidly” and they were publishing their “initial thoughts” in “good faith to assist the global response”.
The team warn that their “early investigations and suggestions require further detailed work and analysis and should not be relied on as constituting any kind of medical or other advice or recommendation”.
There is currently no specific treatment against coronavirus, but Gilead’s drug remdesivir and anti-HIV drugs are the leading drug candidates.
Remdesivir was originally developed as a drug against ebola but wasn’t effective.
Researchers from Wuhan in China have found remdesivir and chloroquine to be highly effective against the coronavirus in vitro. The team published a letter in Cell Research on 4 February.
The first US patient with coronavirus was treated with remdesivir, according to a paper in NEJM published in January.
Trials are now under way in China to test remdesivir against coronavirus in people with the infection.
Until a treatment emerges, supportive care is the mainstay of coronavirus management, including oxygen, IV fluids and mechanical ventilation for severe cases.