Cytokine storm patients......

20,363 Views | 113 Replies | Last: 4 yr ago by jagvocate
TRADUCTOR
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Any type of interferon reasonable? for any stage of COVID?
dermdoc
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I actually think that is why plaquenil works. The porphyrin stuff on RBCs
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PatriotAg98
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Marcus Aurelius said:

Witnessing another one. Symptom day 10 sudden huge spike in ferritin, CRP, LFTs and neutrophil/lymphocyte ratio. Chest x-ray ARDS exploding. Max vent, proned. New onset renal failure and shock. Depressing. Nothing to do but watch the inevitable play out. Steroids? Can't get compassionate IL-6 inhibitors now.
Actemra(tocilizumab) is unavailable in your hospital??
Marcus Aurelius
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correct
PatriotAg98
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I DM'd you
Marcus Aurelius
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Wow thanks man. Hope this works.
ham98
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Marcus Aurelius said:

Wow thanks man. Hope this works.
Aggie networking at its finest!
jturner181
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Gents - a non medical professional likely asking a dumb question - but will blood doping, EPO, other oxygen enhancing mixtures be effective here when IL-6 inhibitors (tocilizumab) aren't available?
DuncanAg
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Can we get a free sub for these docs? Heck...I will pay for it.

We appreciate you guys more than you will ever know!!
Marcus Aurelius
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Talked to our head pharm-D. She is calling the appropriate people tonight. She will request a compassionate usage order. THX again.
NawlinsAg01
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Quote:

Outside of select centers, you pretty much have to enroll the patient in a clinical trial in order to get them right now.
Infection_Ag or Marcus, Are y'all participating in any COVID studies? There are a ton ongoing or just about to start up, many focusing on the inflammation aspect in these severe cases.
Marcus Aurelius
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We are looking into it. Sure you saw the FDA phase III trial approval recently.
McInnis 03
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Kevzara is also getting the same compassionate use as Actemra isn't it?
McInnis 03
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FriscoKid said:

McInnis 03 said:

This is ludicrous. We've known about the ability and need of the il6 drugs since South Korea started spreading the word weeks ago...

I'm sorry


There are some outside eyes poking around this board. Maybe someone will pick this up and get it to the right people.


Blue star for you
Infection_Ag11
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NawlinsAg01 said:

Quote:

Outside of select centers, you pretty much have to enroll the patient in a clinical trial in order to get them right now.
Infection_Ag or Marcus, Are y'all participating in any COVID studies? There are a ton ongoing or just about to start up, many focusing on the inflammation aspect in these severe cases.


Yes, sarilumab and remdesivir. We have toci in limited quantities.
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NawlinsAg01
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Today was Humanigen right? There's a ton of earlier phase stuff coming through as well. Hoping some of it pans out.
NawlinsAg01
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Good. Those were very quick to get going but I hear supplies are limited at each site. A friend in NJ said they received drug to treat 5 patients and they have >100.
REGN has additional studies in the works, as does just about everyone else. This is the most collaboration I've seen between agency, investigators, pharma and CRO in my entire career....thank you guys on the front lines.
Marcus Aurelius
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Man thank you too. Your ER pearls thread was/is awesome. Inspiring.
saltyoldguy
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Marcus Aurelius said:

Talked to our head pharm-D. She is calling the appropriate people tonight. She will request a compassionate usage order. THX again.
Dm'd you
saltyoldguy
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Double post Dm'd you
robdobyns
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Leronlimab

CytoDyn, developer of leronlimab announced in a press release that after 3 days of treatment with leronlimab, 8 patients with COVID-19 who are seriously ill have shown an improvement in several important immunologic biomarkers, including cytokines, interleukin (IL)-6, and a trend toward the normalization of the CD4/CD8 ratio.5

"We are very pleased with our most recent laboratory data for patients treated with leronlimab for COVID-19 infection. We continue to see increases in the profoundly decreased CD8 T-lymphocyte percentages by Day 3, normalization of CD4/CD8 ratios, and resolving cytokine production including reduced IL-6 correlating with patient improvement. The current data suggests a trend toward the restoration of immune function and mitigation of the cytokine storm. This is consistent with prior laboratory results in the first four patients treated for COVID-19 with leronlimab," Bruce Patterson, MD, CEO and founder of IncellDx, a partner of CytoDyn's, said in a statement.5

The randomized, double-blind, placebo-controlled phase II study of leronlimab as treatment of COVID-19 is expected to include 75 patients from up to 10 treatment centers in the United States. CytoDyn has also filed for the initiation of a phase II/III trial for the treatment of severely ill patients with COVID-19. This double-blind trial is expected to enroll 342 patients and randomize them in a 2:1 ratio. The primary end point of this trial is the mortality rate at 14 days.6
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robdobyns
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The press release was published online by Targeted Oncology tonight at 8 PM.
This experimental drug might be available. It's a very small biotech company so they should be quick on their feet.
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Marcus Aurelius
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robdobyns said:

The press release was published online by Targeted Oncology tonight at 8 PM.
This experimental drug might be available. It's a very small biotech company so they should be quick on their feet.
Excellent. THX.
kyledr04
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Has anyone used or considered the JAK inhibitors? They haven't gotten as much coverage but there's early literature and COVID trials starting. I makes sense if IL6 is as critical as we think since the JAK path is kicked off by IL6. If other cytokines are also problematic inhibiting JAK would prevent their actions as well.

Also, the reported WBC abnormalities are very interesting. Almost like a type of leukemia. There might be room there for other treatments.
380Ag
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Phase 3 Trial

Maybe some help on the way...
Jbiv230987
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Just passing along as some additional thinking on the possible cause...


https://t.co/XuqjcziRLY?amp=1
Not a Bot
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Jbiv230987 said:

Just passing along as some additional thinking on the possible cause...


https://t.co/XuqjcziRLY?amp=1


This is really interesting. Thanks for sharing.

$3 Sack of Groceries
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The links in the three posts above mine are very good reads for an average shlub like me. Thank y'all so much for posting.

So let's say the particular medication discussed in the first release turns out to be truly effective...how long does it realistically take to get those meds distributed and into the hands of doctors treating relevant patients?
NawlinsAg01
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Standard timelines? 6 months. Now? Could be a couple of weeks. We saw one highly sought-after therapy approved by FDA in less than 48hrs, IRBs same day it was submitted, patient treated the next day. Like I said above, amazing collaboration right now.
NawlinsAg01
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Quote:

Man thank you too. Your ER pearls thread was/is awesome. Inspiring.
I can't take credit for that, I manage clinical trials from behind a laptop all day. That was a different NawlinsAg sharing his awesome first-hand info.
Ranger222
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Yes JAK inhibitors should definitely be under consideration. Saw Novartis was starting a trial.

Here is a preprint this morning I found looking at the virus-host interatome and they suggest that viral nonstructure proteins are interacting with an NF-kB repressor that leads to high IL6/IL8 levels and neutrophil migration to the lungs. They suggest IL6, IL8 and JAK1 and JAK3 inhibitors

dermdoc
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kyledr04 said:

Has anyone used or considered the JAK inhibitors? They haven't gotten as much coverage but there's early literature and COVID trials starting. I makes sense if IL6 is as critical as we think since the JAK path is kicked off by IL6. If other cytokines are also problematic inhibiting JAK would prevent their actions as well.

Also, the reported WBC abnormalities are very interesting. Almost like a type of leukemia. There might be room there for other treatments.
Some great ideas. Thanks.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
Newoldarmy
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I have no ****ing clue what you guys are talking about but I thank God y'all are doing it, for you, and for your work.
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Greenlander
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Jbiv230987 said:

Just passing along as some additional thinking on the possible cause...


https://t.co/XuqjcziRLY?amp=1


This article references Avigan as a possible treatment. Do we have wide access to Avigan in the US?
 
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