Researchers at the University of Oxford are working alongside NHS associates as part of a team to carry out a new clinical drug trial to aid treatment of COVID-19. The trial will examine the “re-purposed” drug’s effectiveness at raising oxygen levels in the blood of COVID-19 patients to improve their chances of recovery.

Current treatments for ensuring high oxygen levels in the blood include oxygen masks and ventilators to support the patient’s breathing. However, Oxford researchers hypothesise that COVID-19 limits how much oxygen is carried around the body through the blood flow. This means that usual methods of assisted breathing and oxygen therapy may be insufficient compared to use with other respiratory illnesses.

To combat this, the trial is using the drug almitrine bismesylate to redirect blood to oxygenated areas of the lung, which is known to work successfully at redirecting blood flow when used in treatment for patients with ARDS (Acute Respiratory Distress Syndrome). The trial’s Lead Researcher, Professor Peter Robbins, described the reasoning behind testing this specific medication in a statement to Oxford University: “We know that almitrine can increase oxygen levels in patients with acute respiratory distress syndrome by constricting the blood vessels in regions of the lung where the oxygen is low. We want to see if almitrine will also have this effect in COVID-19 patients.”

Almitrine will be used in clinical trials in selected areas across the UK, and will examine the effect of the drug on two different groups. The first group will be made up of those who need breathing support and will measure the oxygen levels in their blood during treatment. The other group are those who do not require assisted breathing, but will be monitored for whether or not  the drug reduces the need for respiratory support.

Professor Robbins further described his hopes for the trial, saying: “If almitrine can add to the overall effectiveness of respiratory support, then the hope is that clinicians will need to mechanically ventilate fewer patients, and that they will be able successfully to support more seriously ill patients throughout the course of their illness.

“People can recover from COVID-19 in the same way that they recover from other viral illnesses. That’s by fighting off the virus with the body’s normal defence mechanisms. But if the lung becomes so damaged that blood just doesn’t pick up enough oxygen, then the body never gets the chance to finish the job and the patient dies from the low level of oxygen. So, what we are really trying to do with supportive therapy is help the patient to continue to function whilst their body fights off the infection in the normal way.”

The trial is being supported by the medical research charity LifeArc, who have given £10 million to finance 15 other drug trials to improve treatments of COVID-19. Funding has been given to studies which use “re-purposed” medicines which are used to treat other conditions or drugs in the late stages of development, as this offers a higher chance of identifying successful treatments faster.

In a statement to Cherwell, Dr Catriona Crombie, Associate Director Technology Transfer at Life Arc, said: “The benefits of conducting trials with repurposed drugs include reduced cost, reduced time and fewer safety concerns. Almitrine has already been shown to have a good safety profile and demonstrated efficacy in people with COPD. “The trial will show almitrine’s effect on oxygenation and whether it is effective in reducing the need for other forms of ventilatory support. It is also hoped that a suitable treatment regime can be established. As almitrine is an existing drug and not novel, it can be manufactured in a few months so it can be made available for severe COVID-19 patients in NHS hospitals if granted access.”