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Fenofibrate for COVID-19

Fenofibrate in tissues is converted into an active metabolite: fenofibric acid. In combination with diet, it is used to treat patients with very high blood triglycerides or lipid disorders.

Fenofibrate reduces viral load in Covid-19

The drug fenofibrate, commonly used for abnormal blood cholesterol levels, was able to reduce the viral load of Covid-19.

In March 2020, at the dawn of the coronavirus pandemic, the World Health Organization announced a multinational clinical trial to compare treatments for Covid-19 patients. At the end of the year, verdicts were handed down on four drugs: none of them proved to be useful.

Although the development of coronavirus vaccines has been a huge global success, they are not suitable for everyone, such as people with hyperimmune disorders and those taking immunosuppressants. At the same time, studies of only two drugs showed a decrease in mortality from Covid-19: the steroid dexamethasone and tocilizumab, a monoclonal antibody that blocks the interleukin-6 receptor. Both drugs do not target the virus itself, but suppress an overactive immune response in critically ill patients, preventing a cytokine storm.

Scientists have named another reason for the cytokine storm in Covid-19. Canadian scientists found that patients with coronavirus significantly increased the level of the protein galectin-9 in the blood plasma. They also found a correlation between this protein and pro-inflammatory processes.

Scientists from the University of Birmingham and Kiel in the UK, as well as the San Raffaele Institute of Science in Italy and the Center for Glycomics in Copenhagen (Denmark), have proposed another drug for the treatment of people infected with coronavirus: fenofibrate. The results of the study were published in a recent article for the journal Frontiers in Pharmacology.

Fenofibrate is an international non-proprietary name for a drug with hypolipidemic, uricosuric, and antiplatelet effects. It is approved in most countries and is generally needed to lower lipids, LDL cholesterol, and triglycerides because it activates lipoprotein lipase and lowers apoprotein CIII, which increases lipolysis and results in the removal of triglyceride-rich plasma particles.

The coronavirus is known to enter the body through the S protein, which binds to the ACE2 receptor. The authors of the work decided to test a group of approved drugs, including fenofibrate, to understand which of them would disrupt the interaction of ACE2 and the spike protein on the surface of SARS-CoV-2. Experiments have shown that fenofibric acid, the active metabolite of fenofibrate, induces ACE2 dimerization and destabilizes the spike receptor binding domain, preventing it from binding to ACE2.

The scientists then tested the in vitro efficacy of fenofibrate in reducing viral load. Fenofibrate and fenofibric acid have been tested by two independent laboratories. Fenofibrate reduced the viral load by about 18-65% in 24 hours, so it can suppress the primary infection. A decrease has also been observed with fenofibric acid, although to a lesser extent. The results were then rechecked 48 hours later and fenofibrate was still effective. At the same time, efficiency was achieved when using safe concentrations of the drug.

Clinical trials of fenofibrate in hospitalized Covid-19 patients are underway at the University of Pennsylvania hospitals.

How to take Fenofibrate

Thus, the drug is able to kill coronavirus in human cells by 70%. In addition, it is effective against most strains of the virus. Generally, fenofibrate is used to lower blood cholesterol levels in patients at risk for cardiovascular disease.

Among its advantages in the treatment of coronavirus, scientists call availability and low cost. Fenofibrate is already a registered drug. This substance is well known and therefore harmless.

The effectiveness of fenofibrate against COVID-19 is determined even at low concentrations of the drug in the usual therapeutic dose.

Take 160 mg orally 3 times a day as an initial dose for the treatment of hypercholesterolemia or a combination of hypercholesterolemia and hypertriglyceridemia.

For the treatment of high triglyceride levels, the initial dose of fenofibrate is 54 to 160 mg per day. It can be gradually increased every 4 to 8 weeks up to a maximum dose of fenofibrate 200 mg daily if triglycerides do not improve.

Possible side effects of fenofibrate

Gallbladder stones, increased levels of transaminases and creatine kinase, nausea, vomiting, diarrhea, myalgia, myositis, acute renal failure, dizziness, headache, abdominal pain, back pain, fatigue, disability, rash. If you experience these symptoms, contact your doctor immediately.

If you miss a dose, take it as soon as you remember. If you are nearing the end of your next dose, skip the missed dose and resume your regular dosing schedule. Any medicine taken in excess can be dangerous. If you suspect an overdose, contact your doctor immediately.

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