The kinase inhibitor acalabrutinib which is an FDA-approved drug for chronic lymphocytic leukaemia could relieve cytokine storm that is often accompanied with the treatment of severe COVID-19 in patients, according to research published in the journal Science Immunology.
Patients with severe COVID-19 may have a hyperinflammatory immune response due to macrophage activation which may be referred to as macrophage activation syndrome, cytokine release syndrome or cytokine storm.
Dr Mark Roschewski, MD and colleagues have found that acalabrutinib could improve the oxygenation levels and decrease molecular markers of inflammation in most patients involved in the observational study.
Acalabrutinib was administered to 11 patients on supplemental oxygen and 8 patients on mechanical ventilation over a duration of 10 to 14-day course of treatment. At the end of the treatment, 8 patients on supplemental oxygen were discharged and could breathe room air, and 4 out of 8 patients on ventilation were extubated with 2 of the patients breathing room air.
The measurements of C-reactive protein and IL-6 related to the inflammation also decreased in the majority of patients, with no signs of toxicity from the drug, noted the authors.
Acalabrutinib acts by inhibiting the Bruton tyrosine kinase (BTK) protein, which helps macrophages to activate innate immune response by inducing various proteins. Some patients with a severe COVID-19 may experience a hyperinflammatory immune response driven by macrophage activation, leading to acute respiratory distress syndrome (ARDS) and may be fatal.
Acalabrutinib will be tested in an international prospective randomised clinical trial which is underway to confirm the observed efficacy in severe COVID-19 patients, revealed the authors.