Coronavirus, first positive results in patients treated with ‘anti-intensive care drug

The hematologists of the ASL Tuscany north west, Enrico Capochiani (director of hematology of the ASL Toscana north west), Emanuela Santantonio (San Luca hospital in Lucca), also thanks to the cultural and scientific comparison with the University, the Cnr and with the contribution of the doctor Spartaco Sani (director of infectious diseases of the North West Asl), have defined specific criteria for select potentially suitable patients. In particular, patients hospitalized in the infectious disease department of the Livorno hospital, with initial respiratory difficulty, but not yet in assisted ventilation, to whom administer an oral drug also recorded for hyper-inflammation conditions.

“To date, 4 patients have already been treated: 3 men and a woman (respecting the typical percentage of the disease) aged between 28 and 72 years. Another 2 started the trial phase today (March 28) “. Explains Dr. Enrico Capochiani. “All 4 patients had recently-onset disease with clinical data confirming Covid-19 pneumonia, but with an uneven picture of assisted pulmonary respiration, even if the clinical conditions already indicated the imminent recourse to intensive care and an upcoming intubation. The first patient treated is in the process of overcoming any form of assisted breathing, the second is in marked improvement and the last two, which have just started, seem to follow the same course “.

“In this perspective – Capochiani concludes – the data that the scientific literature has presented in recent weeks, seem to suggest that the COVID-19 pictures that evolve negatively with the need for resuscitation support, have many characteristics similar to the immune reactions deriving from hematological pathologies and that consequently, the same treatments can be effective “.

“The goal of Tuscan doctors – underlines Spartaco Sani – on the one hand is to find drugs that reduce the amount of virus in the patient (antiviral therapies), but on the other hand to also find drugs that prevent the critical evolution of the infection. It is on this aspect that hematologists, infectious disease specialists and resuscitators of the ASL Toscana north west, have focused their interest, that is to define a treatment that can avoid the progression of COVID-19 from domestic disease to subintensive disease to resuscitation department disease, so as to increase the percentage of patients and in any case reduce the load on the intensive care units “.

The literature, the mechanisms of action, the times of efficacy have led to the use of drugs inhibiting a specific pro-inflammatory system called JAK-STAT. Among the active medicines, ruxolitinib, (JAKAVI), a Novartis drug that the company provided with AIFA consent in off-label mode, was selected by the hematologists of the ASL in north-west Tuscany, for its effectiveness and speed. The off-label use concerns molecules already known and used for some time, for which there are conspicuous scientific evidences that would allow their rational use even in clinical situations and in ways not foreseen by the technical data sheet and in the package insert. “The Tuscany Region – Letizia Casani affirms – is following this opportunity carefully and we hope that this drug will not allow patients to get to intensive care with a start of respiratory crisis, instead guaranteeing their faster recovery, also leading to one more chance for those who will however need intensive care “. In order to consolidate the scientific evidence for the benefit of a therapeutic treatment potentially relevant for a large-scale fight against complications from acute respiratory syndrome triggered by COVID-1, the Tuscany Region will shortly start an official trial of the new drug shared with Aifa.