AUSTIN, Texas—St. David’s Medical Center is testing two promising COVID-19 therapies in clinical trials. The medications being tested are lenzilumab and ruxolitinib, both of which focus on inflammatory pathways in severe COVID-19 cases but with different approaches. The Principal Investigators are infectious disease specialists Matthew Robinson, MD, for the lenzilumab study and Brian Metzger, MD, for the ruxolitinib study.
Lenzilumab targets stage 3 COVID-19 infections, or more specifically the cytokine storm that occurs at this stage. Cytokines are normally beneficial molecules the body uses to signal an immune reaction. When the body is severely afflicted from COVID-19, however, the cytokines are released in abnormally high quantities and cause inflammation in multiple organs that can be fatal. Lenzilumab tries to block this by targeting the GM-CSF proteins that trigger their release. The FDA has already authorized this new drug for compassionate use in COVID-19 cases, which allows patients to receive treatment without waiting for complete FDA approval that usually takes years.
Ruxolitinib has already been approved as a treatment for myelofibrosis, or bone marrow cancer. The drug is being studied for its ability to target Acute Respiratory Distress Syndrome, a complication of severe COVID-19 where inflammation causes fluid buildup in lungs. The mechanism that ruxolitinib uses to target myelofibrosis may inhibit cytokine signaling as well. Instead of GM-CSF proteins, Ruxolitinib inhibits the activation pathways on the surface of immune cells , which are also thought to play a role in inflammation. Ruxolitinib was also granted for compassionate use authorization by the FDA.
Researchers of both studies hope that advances with these medications may reduce the need for the use of ventilators with COVID patients or make it possible for patients to be taken off of them sooner. Lenzilumab can be given before or during the cytokine storm to prevent ventilator use, while ruxolitinib is given during ventilator use in hopes of reversing fluid buildup in lungs. Though the studies are still in the process of collecting data, Dr. Robinson notes that patients seem to be recovering much more quickly than usual. The research teams have enrolled around 15-20 patients so far and hope to enroll several more.