Genetics can help identify potential drugs for early treatment of COVID-19: Study

A recent study using human genetics suggests that researchers should prioritize clinical trials of drugs that target two proteins to manage COVID-19 in its early stages. Based on the analysis, the researchers called for prioritising clinical trials of drugs targetting the proteins IFNAR2 and ACE2. According to the study, which was published in the journal Nature Medicine, the goal is to identify existing drugs, either FDA-approved or in clinical development for other conditions, that can be repurposed for the early management of COVID-19. 

The study explained that IFNAR2 is the target for approved drugs often used by patients with relapsing forms of the central nervous system disorder multiple sclerosis. The researchers believe that the most promising ACE2 therapy against coronavirus is a drug that was developed before the pandemic began and has been evaluated in clinical trials to reduce the inflammatory response in patients with severe respiratory disorders. 

Dr Juan P. Casas, a physician epidemiologist at the Veterans Affairs Boston Healthcare System, said, “When we started this project early last summer, most COVID-19 trials were being done on hospitalized patients”. 

He added, “The problem we tried to overcome is how to identify if existing drugs, either approved or in clinical development for other conditions, can be repurposed for the early management of Covid-19”. 

'If findings are correct, there's need to test this strategy...'

Casas went on to explain that ACE2 is highly relevant to COVID-19 because the coronavirus uses that protein to enter human cells. He said that the most promising ACE2 therapy against COVID is the drug APN01, which mimics the protein. According to the study, the drug works by confusing the coronavirus so it attaches to the drug instead of ACE2 protein in the human cell. The study said that positive evidence is emerging from small clinical trials on the effectiveness of APN01 in COVID-19 patients, especially those that are hospitalised. 

“Hence, if our genetic findings are correct, there’s a need to test this strategy in clinical trials in COVID-19 outpatients,” Casas said. 

He added that his team also showed that people with a certain variant of IFNAR2 had less chance of being hospitalised due to COVID-19, compared to people without the variant. Casas said that he sees a continued need for drugs to treat people in the early phase of COVID-19, despite the ongoing worldwide vaccination campaigns. He added that this is largely due to two reasons - first being that it will take some time to achieve the high levels of vaccine coverage needed to create herd immunity and secondly, certain coronavirus variants are emerging that seem to lead to a reduced vaccine efficiency. “We are not yet in clear,” Casas said. 

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