Can Bepridil, The Angina Drug, Treat COVID-19?

As time is passing by and the pandemic still seems to be ravaging through the world, researchers are working round the clock to try and find ways to combat the SARS-CoV-2, the virus that is causing COVID-19 infections. It has been just a little over one year since the novel coronavirus was declared to be a pandemic. During this time, millions of people have tested positive, and millions more have died from it. Finding ways to decrease the spread of the virus has been the primary focus of researchers, governments, and pharmaceutical companies around the world. Recent research has now shown that a drug called Bepridil could be effective in treating patients with COVID-19. However, can Bepridil, an angina drug, really treat COVID-19? Let’s take a look.

Brief Look at COVID-19 Treatments

Over the last one year, researchers and scientists from all over the world have been studying various treatments in hopes of managing COVID-19. In the last year, over 111 million people have tested positive for the novel coronavirus, and almost 2.5 million people have died from the infection.(1,2,3,4) In the previous one year, scientists have continued to study several drugs that have been approved by the US Food and Drug Administration to understand if they may play a role in reducing the symptoms of COVID-19. However, only a few of these drugs have sown any real promise.(5,6)

For example, Remdesvir, which is a medication prescribed to people with Ebola, was one of the first drugs to be approved by the Food and Drug Administration for the treatment of COVID-19. (7) Remdesivir was found to help slow down the replication of the novel coronavirus in the body, thus reducing the recovery time of 15 days to 10 days.(8)

Another drug that has been approved by the Food and Drug Administration for other purposes but has been found to be helpful in the treatment of COVID-19 is dexamethasone. Dexamethasone is a corticosteroid that is used to reduce inflammation in the body.(9,10) Dexamethasone has been prescribed to some people with the novel coronavirus infection who were experiencing respiratory issues. Ever since then, doctors have started prescribing dexamethasone to people with COVID-19. It has been noticed that the death rate in these patients went down.(11)

Similarly, the Food and Drug Administration had granted emergency approval for using the drug hydroxychloroquine for the treatment of COVID-19, but the approval has been revoked since then.(12) Apart from this, the Food and Drug Administration also warned that there were safety issues in using hydroxychloroquine for treating COVID-19.(13)

Bepridil for COVID-19

Research from the Texas A&M University led the bepridil study, which is published in the journal Proceedings of the National Academy of Sciences of the United States of America.(14) The research team studied 55 drugs in order to find a medication with prior approval from the Food and Drug Administration for finding an alternative to remdesivir. The team discovered that six medications might be effective in stopping the replication of the virus, and bepridil showed the most promise.

Bepridil is traditionally used for the treatment of angina, which is a condition that occurs when there is less than normal blood oxygen reaching a particular part of the heart muscle.(15)

According to researchers of the new study, bepridil is a calcium blocker that has major antianginal activity. Administering a high dose of bepridil can slow down the replication of the virus in the host cells by increasing the pH of endosomes and also inhibiting Mpro.

This theory was tested by the research team by injecting the virus in both human cells and African green monkey cells. Furthermore, they also tested bepridil in three different concentrations. They discovered that the greater concentration of bepridil was effective in inhibiting the replication of SARS-CoV-2.

On the whole, the results indicated that bepridil is effective in preventing SARS-CoV-2 from entering and replicating in mammalian cell hosts. The study, therefore, recommended further clinical trials of bepridil for the treatment of COVID-19.

Conclusion

It is important to know that bepridil is not yet available as a prescription drug for the treatment of COVID-19 in the United States.(16) The manufacturers of bepridil voluntarily withdrew the medication from being sold as there were some concerns that it could cause heart problems. However, bepridil is still prescribed for treating angina in countries like China, France, and Japan.

References:

  1. Johns Hopkins Coronavirus Resource Center. 2021. COVID-19 Map – Johns Hopkins Coronavirus Resource Center. [online] Available at: <https://coronavirus.jhu.edu/map.html> [Accessed 24 March 2021].
  2. Roser, M., Ritchie, H., Ortiz-Ospina, E. and Hasell, J., 2020. Coronavirus disease (COVID-19)–Statistics and research. Our World in data, 4.
  3. Worldometers.info. 2021. Coronavirus Update (Live): 124,974,840 Cases and 2,749,081 Deaths from COVID-19 Virus Pandemic – Worldometer. [online] Available at: <https://www.worldometers.info/coronavirus/> [Accessed 24 March 2021].
  4. Covid19.who.int. 2021. [online] Available at: <https://covid19.who.int/table> [Accessed 24 March 2021].
  5. U.S. Food and Drug Administration. 2021. Coronavirus (COVID-19) | Drugs. [online] Available at: <https://www.fda.gov/drugs/emergency-preparedness-drugs/coronavirus-covid-19-drugs> [Accessed 24 March 2021].
  6. U.S. Food and Drug Administration. 2021. Coronavirus Treatment Acceleration Program (CTAP). [online] Available at: <https://www.fda.gov/drugs/coronavirus-covid-19-drugs/coronavirus-treatment-acceleration-program-ctap> [Accessed 24 March 2021].
  7. National Institutes of Health (NIH). 2021. Final report confirms remdesivir benefits for COVID-19. [online] Available at: <https://www.nih.gov/news-events/nih-research-matters/final-report-confirms-remdesivir-benefits-covid-19> [Accessed 24 March 2021].
  8. Beigel, J.H., Tomashek, K.M., Dodd, L.E., Mehta, A.K., Zingman, B.S., Kalil, A.C., Hohmann, E., Chu, H.Y., Luetkemeyer, A., Kline, S. and Lopez de Castilla, D., 2020.
  9. Remdesivir for the treatment of Covid-19. New England Journal of Medicine, 383(19), pp.1813-1826.
  10. Lammers, T., Sofias, A.M., van der Meel, R., Schiffelers, R., Storm, G., Tacke, F., Koschmieder, S., Brümmendorf, T.H., Kiessling, F. and Metselaar, J.M., 2020.
  11. Dexamethasone nanomedicines for COVID-19. Nature nanotechnology, 15(8), pp.622-624.
  12. Johnson, R.M. and Vinetz, J.M., 2020. Dexamethasone in the management of covid-19.
  13. Group, T.R.C., 2020. Dexamethasone in hospitalized patients with Covid-19—preliminary report. The New England journal of medicine.
  14. Sinha, N. and Balayla, G., 2020. Hydroxychloroquine and covid-19. Postgraduate medical journal, 96(1139), pp.550-555.
  15. U.S. Food and Drug Administration. 2021. FDA cautions use of hydroxychloroquine/chloroquine for COVID-19. [online] Available at: <https://www.fda.gov/drugs/drug-safety-and-availability/fda-cautions-against-use-hydroxychloroquine-or-chloroquine-covid-19-outside-hospital-setting-or> [Accessed 25 March 2021].
  16. Vatansever, E.C., Yang, K.S., Drelich, A.K., Kratch, K.C., Cho, C.C., Kempaiah, K.R., Hsu, J.C., Mellott, D.M., Xu, S., Tseng, C.T.K. and Liu, W.R., 2021. Bepridil is potent against SARS-CoV-2 in vitro. Proceedings of the National Academy of Sciences, 118(10).
  17. Zusman, R.M., Higgins, J., Christensen, D. and Boucher, C.A., 1993. Bepridil improves left ventricular performance in patients with angina pectoris. Journal of cardiovascular pharmacology, 22(3), pp.474-480.
  18. Accessdata.fda.gov. 2021. [email protected]: FDA-Approved Drugs. [online] Available at: <https://www.accessdata.fda.gov/scripts/cder/daf/index.Cfm?event=overview.process&ApplNo=019002> [Accessed 25 March 2021].

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