Methylprednisolone effective in treating critically ill patients
Almost exactly one year ago, the US was experiencing the first wave of COVID-19. In March 2020, SARS-CoV2 is defying all modern medical knowledge and technology killing people at a rate of 1,500 daily, in US alone. WHO recommends against use of steroids for COVID-19 patients. At about the same time, the first mRNA datasets characterizing the blood transcriptome in severe cases becomes available. A couple of days later, iPathwayGuide identifies several existing drugs that are predicted to help in severe cases. The top drug is methylprednisolone (MP) which contradicts flagrantly the WHO recommendations. Interestingly, not all steroids are predicted to be equally effective. The results are validated in several independent data sets and the beneficial effects of MP are confirmed in a clinical study undertaken at Henry Ford Health System. The paper describing this work is now peer-reviewed and published and can be found here. You can find the original press release here.
It took us about one month to clinically validate the finding, and about 10 months to get the paper published. It was slow, and painful, and we cannot help you with any of that. However, it only took a couple of days from having the data, to having a complete molecular characterization of the disease, identify the key processes and mechanisms, and identify an actionable drug. This part can be easy, fast, and dead accurate as shown by the methylprednisolone story. If you want to understand your phenotype, its mechanisms, and you are looking for drugs or drug targets, we can help you with it!
Independent validation shows clinical efficacy
The independent clinical study undertaken at Henry Ford Health Systems and led by Dr. Mayur S. Ramesh, has shown in a cohort of over 200 patients that a short course of methylprednisolone was able to significantly reduce transfers to ICU, requirements for ventilation, as well as mortality. A protocol was implemented on March 20, 2020 using early, short-course, methylprednisolone 0.5 to 1 mg/kg/day divided in 2 intravenous doses for 3 days. Outcomes of pre- and post-corticosteroid groups were evaluated. The patient cohort included 213 eligible subjects, 81 (38%) and 132 (62%) in pre-and post-MP groups, respectively. The mortality was reduced by approximately 50% from 26.3% to 13.6%. The respiratory failure requiring mechanical ventilation was reduced from 36.6% to 21.7% and the escalation to intensive care units was reduced from 44.3% to 27.3%. Full details of the clinical study can be found in the peer-reviewed article published in the journal Clinical Infectious Diseases.
In addition to the paper, we intend to make all data, as well as the results of the analysis available in iPathwayGuide. If you are interested to access these data and the analysis, subscribe to our newsletter which will be used to announce when these are made available, as well as provide the details on how to access the data. Your contact information will not be shared with anyone.
Please note that this drug will not prevent infection and will not kill the virus. This is expected to be used only in severe cases, in a hospital setting, and should be administered only if deemed necessary by an attending physician. The best way to protect yourself from getting COVID-19 is a vaccine.
* In the meantime, WHO has changed its recommendations and now does recommend the use of steroids in severe cases of COVID-19.