{"id":164,"date":"2020-05-08T21:25:44","date_gmt":"2020-05-09T04:25:44","guid":{"rendered":"https:\/\/reallycorrect.com\/ReallyCorrectWp1\/?page_id=164"},"modified":"2020-12-14T11:08:46","modified_gmt":"2020-12-14T19:08:46","slug":"therapeutics","status":"publish","type":"page","link":"https:\/\/reallycorrect.com\/ReallyCorrectWp1\/therapeutics\/","title":{"rendered":"COVID-19 Therapeutics and Advanced Supportive Care"},"content":{"rendered":"\n

Therapeutic drugs and other therapies are being aggressively debated, tested, used under compassionate-use expanded access and the like. Below are articles that may be of interest. Really Correct has no strong opinion other than compassionate-use doctor options are good when risks and contraindications are well known or life saving choices are limited. Perhaps obviously, the more severe the case, the less there is to lose when a doctor is trying to save a life with a compassionate-use medical gamble. Also see Severe Treatment<\/a> and Staying Healthy<\/a>.<\/p>\n\n\n\n

Monoclonal Antibodies<\/h3>\n\n\n
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Coronavirus (COVID-19) Update: FDA Authorizes Monoclonal Antibodies for Treatment of COVID-19<\/div>
The FDA issued an EUA for two monoclonal antibodies to be administered together for treating mild to moderate COVID-19 in adults and pediatric patients.<\/div><\/div><\/div>\n\n
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The FDA-approved drug ivermectin inhibits the replication of SARS-CoV-2 in vitro<\/div>
Although several clinical trials are now underway to test possible therapies, the worldwide response to the COVID-19 outbreak has been largely limited\u2026<\/div><\/div><\/div>\n\n
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Regeneron\u2019s Casirivimab and Imdevimab Antibody Cocktail for COVID-19 is First Combination Therapy to Receive FDA Emergency Use Authorization | Regeneron Pharmaceuticals Inc.<\/div>
TARRYTOWN, N.Y. , Nov. 21, 2020 \/PRNewswire\/ — First treatment of any kind to have prospectively confirmed and statistically significant anti-viral activity against SARS-CoV-2 Authorized for recently diagnosed, mild to moderate COVID-19 in high-risk patients Initial doses of REGEN-COV2 will be<\/div><\/div><\/div>\n\n\n

Immunosuppressants, Steroids, Tocilizumab, Cyclosporine A, Etc.<\/h3>\n\n\n
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Budesonide – Wikipedia<\/div>
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Corticosteroid inhalers used by asthma patients may help treat COVID-19, researchers to begin human clinical trials – Health News , Firstpost<\/div>
The ultimate goal of the trial is to analyse if the Budesonide inhaler can be used as a low-cost and easily available early intervention therapy for COVID-19 patients to reduce the risks of severe respiratory illness.<\/div><\/div><\/div>\n\n
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Ciclesonide – Wikipedia<\/div>
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UB researchers launch study to learn if an asthma treatment can ease Covid-19<\/div>
Read the full story from News Reporters Samantha Christmann and Jonathan Epstein.<\/div><\/div><\/div>\n\n
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Covis Pharma B.V. Initiates Phase 3 Clinical Trial of Alvesco (Ciclesonide) Inhaler for the Treatment of COVID-19<\/div>
\/PRNewswire\/ — Covis Pharma B.V. today announced the initiation of a Phase 3 clinical study to assess the safety and efficacy of its asthma drug Alvesco…<\/div><\/div><\/div>\n\n
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Dexamethasone – Wikipedia<\/div>
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Methylprednisolone – Wikipedia<\/div>
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Methylprednisolone as Adjunctive Therapy for Patients Hospitalized With COVID-19 (Metcovid): A Randomised, Double-Blind, Phase IIb, Placebo-Controlled Trial<\/div>
AbstractBackground. Steroid use for COVID-19 is based on the possible role of these drugs in mitigating the inflammatory response, mainly in the lungs, trigger<\/div><\/div><\/div>\n\n
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Tocilizumab in patients with severe COVID-19: a retrospective cohort study<\/div>
Treatment with tocilizumab, whether administered intravenously or subcutaneously,
\nmight reduce the risk of invasive mechanical ventilation or death in patients with
\nsevere COVID-19 pneumonia.<\/div><\/div><\/div>\n\n
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Roche\u2019s Tocilizumab May Not Improve COVID-19 Pneumonia<\/div>
An Italian study did not observe a benefit for early COVID-19 pneumonia patients who were given tocilizumab, Roche\u2019s RA drug marketed as Actemra.<\/div><\/div><\/div>\n\n
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S1568997220301300?fbclid=IwAR2yKHZmAVm20oOzSTm6E0lo3od6-mDYh63pDdFXaGBit96fiefETVXJA_w<\/div><\/div><\/div>\n\n
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COVID-19 Outcomes in 4712 consecutively confirmed SARS-CoV2 cases in the city of Madrid.<\/div>
There is limited information describing features and outcomes of patients requiring hospitalization for COVID19 disease and still no treatments have clearly demonstrated efficacy. Demographics and clinical variables on admission, as well as laboratory markers and therapeutic interventions were extra\u2026<\/div><\/div><\/div>\n\n
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Kallikrein-kinin blockade in patients with COVID-19 to prevent acute respiratory distress syndrome<\/div>
The kinin-kallikrein system is a crucial target for the treatment of COVID-19.<\/div><\/div><\/div>\n\n\n

Anticoagulants<\/h2>\n\n\n
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guidelines-for-anticoagulation-in-hospitalized-covid-19-patients.pdf?la=en<\/div><\/div><\/div>\n\n
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COVID-19 and VTE-Anticoagulation – Hematology.org<\/div>
COVID-19 and VTE-Anticoagulation<\/div><\/div><\/div>\n\n
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guidance-from-mass-general-hematology.pdf<\/div><\/div><\/div>\n\n
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SCCM | Anticoagulation guidelines for COVID 19 patients<\/div>
This resource details anticoagulation guidelines for COVID-19 patients. This is a community developed COVID-19 microlearning resource.<\/div><\/div><\/div>\n\n
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COVID-19-Anticoagulation-Algorithm-version_final_1.1.pdf<\/div><\/div><\/div>\n\n
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Antithrombotic Therapy | Coronavirus Disease COVID-19<\/div>
Read about the use of drugs to reduce blood clot formation in people with COVID-19.<\/div><\/div><\/div>\n\n
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The Role of Anticoagulation in COVID-19-Induced Hypercoagulability<\/div>
We aim to provide a comprehensive analysis of hypercoagulability in individuals affected by COVID-19. Our goal is to describe the hypercoagulable state related to the infection and provide guidance regarding the possible benefits of anti-coagulation with …<\/div><\/div><\/div>\n\n\n

https:\/\/www.umc.edu\/CoronaVirus\/Mississippi-Health-Care-Professionals\/Clinical-Resources\/Patient%20Treatment%20Guidelines\/Anticoagulation%20Dosing%20Recommendations.html<\/a><\/p>\n\n\n

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Prevention, Diagnosis, and Treatment of VTE in Patients With Coronavirus Disease 2019<\/div>
Emerging evidence shows that severe coronavirus disease 2019 (COVID-19) can be complicated
\nby a significant coagulopathy, that likely manifests in the form of both microthrombosis
\nand VTE. This recognition has led to the urgent need for practical guidance regarding
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Hydroxycloroquine \/ Cloroquine (+ Antibiotics)<\/h3>\n\n\n
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Chloroquine is a potent inhibitor of SARS coronavirus infection and spread<\/div>
Severe acute respiratory syndrome (SARS) is caused by a newly discovered coronavirus (SARS-CoV). No effective prophylactic or post-exposure therapy is currently available.We report, however, that chloroquine has strong antiviral effects on SARS-CoV infection …<\/div><\/div><\/div>\n\n
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Observational Study of Hydroxychloroquine in Hospitalized Patients with Covid-19 | NEJM<\/div>
Original Article from The New England Journal of Medicine \u2014 Observational Study of Hydroxychloroquine in Hospitalized Patients with Covid-19<\/div><\/div><\/div>\n\n
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Hydroxychloroquine in patients with mainly mild to moderate coronavirus disease 2019: open label, randomised controlled trial<\/div>
Objective To assess the efficacy and safety of hydroxychloroquine plus standard of care compared with standard of care alone in adults with coronavirus disease 2019 (covid-19). Design Multicentre, open label, randomised controlled trial. Setting 16 government designated covid-19 treatment centres \u2026<\/div><\/div><\/div>\n\n\n

Notably, the May 22 2020 release study (below) appeared to be in context of high dose HCQ on the order of 600 to 780 mg per day whereas malaria dosages are 200 to 400 mg per week. Lupus and arthritis doses 200 to 400 mg per day. Maybe less is more? More research on control group characteristics desirable. Patient disease severity stage not yet reviewed. Generally known from other sources that HCQ is not effective late stage and claims of effectiveness from other sources were during early stage. Review incomplete, but results of this study looks like high dosages are likely harmful, possibly even to patients with healthy hearts. HCQ well known to be contra-indicated when patient on beta blockers or other heart health issues – prescription only even for malaria and lupus use. Is there a study of low dose use such that heart health is less impacted? While there is still some potential that HCQ is helpful in low doses in early infection stages, the comic relief we may want to consider is in the following video segment. Again, there may be some place for HCQ in COVID-19 treatment (prophylaxis?) but enjoy the needed humor relief indicating it does not appear to be as promising as once thought.<\/p>\n\n\n\n

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