ProfG has suggested that teriflunomide may be anti-viral. So what does it do against COVID-19?.. I don’t know? But studies from arthritis can give us a clue. Why because, when you take leflunomide in arthritis…it breaks down to be teriflunomide. So what happens with leflunomide in COVID-19?. Maybe ProfG is on to something…interesting..it needs a proper study
Efficacy and Safety of Leflunomide for Refractory COVID-19: An Open-label Controlled StudyWang, Q., Guo, H., Li, Y., Jian, X., Hou, X., Zhong, N., Fei, J., Su, D., Bian, Z., Zhang, Y., Hu, Y., Sun, Y., Yu, X., Li, Y., Jiang, B., Li, Y., Qin, F., Wu, Y., Gao, Y., Hu, Z.10.1101/2020.05.29.20114223 — Posted: 2020-06-02
OBJECTIVE To evaluate the safety and efficacy of leflunomide for the treatment of refractory COVID-19 in adult patients.
DESIGN Open-label controlled study
SETTING A designated hospital for patients with refractory COVID-19 in Wuhan, China.
PARTICIPANTS 27 hospitalized adult patients (≥18 years of age) with radiologically confirmed pneumonia and SARS-CoV-2 positive for more than 28 days despite standard care were assigned to receive standard of care (SOC, grp I) or leflunomide + SOC (grp 2). After 2 weeks, grp 1 and grp 2 patients who continued to be SARS-CoV-2-positive received leflunomide for 14 days while continuing SOC.
MAIN OUTCOME MEASURES The primary outcomes were the rate of and time to SARS-CoV-2 clearance and the 14-day and 30-day hospital discharge rate.
RESULTS Twelve patients enrolled in grp 1 and 15 patients were in grp 2. The 14 days SARS-CoV-2 viral clearance rate was 80.0% (12/15) for grp 2 patients receiving leflunomide versus 16.7% for grp 1 patients (2/12) (P=0.002). By day 14, the median time to SARS-CoV-2 clearance was 6.0 days (range 1-12; IQR 1-12) for grp 2 patients. In grp 1, two patients converted to viral negative on days 1 and 6 (P=0.002). The 14-day discharge rate was 73.3% (11/15) for the grp 2 versus 8.3% (1/12) for grp 1 (P=0.001). The 30-day discharge rate was 100% (15/15) for the grp 2 versus 66.7% (8/12) for grp 1. No severe adverse events or deaths were reported.
CONCLUSION Leflunomide is effective in enhancing SARS-CoV-2 clearance and hospital discharge in refractory COVID-19 patients. The addition of leflunomide to SOC did not increase adverse events versus SOC. These preliminary observations underscore a need for a randomized clinical study of leflunomide in SARS-CoV-2 infection.