Pentoxifylline Effects on Hospitalized COVID-19 Patients with Cytokine Storm Syndrome: A Randomized Clinical Trial

被引:5
作者
Sarhan, Rania M. [1 ]
Altyar, Ahmed E. [2 ,3 ]
Warda, Ahmed Essam Abou [4 ]
Saied, Yasmine Mohamed [5 ]
Ibrahim, Haytham Soliman Ghareeb [6 ]
Schaalan, Mona F. [7 ]
Fathy, Shaimaa [7 ]
Sarhan, Neven [7 ]
Boshra, Marian S. [1 ]
机构
[1] Beni Suef Univ, Fac Pharm, Clin Pharm Dept, Bani Suwayf 62511, Egypt
[2] King Abdulaziz Univ, Fac Pharm, Dept Pharm Practice, POB 80260, Jeddah 21589, Saudi Arabia
[3] Batterjee Med Coll, Pharm Program, POB 6231, Jeddah 21442, Saudi Arabia
[4] October 6 Univ, Fac Pharm, Clin Pharm Dept, Giza 12585, Egypt
[5] Cairo Univ, Fac Pharm, Microbiol & Immunol Postgrad Program, Cairo 11828, Egypt
[6] El Fayoum Univ, Fac Med, Cardiol Dept, Al Fayyum 63514, Egypt
[7] Misr Int Univ, Fac Pharm, Clin Pharm Dept, Cairo 11828, Egypt
关键词
pentoxifylline; severe acute respiratory syndrome; cytokines release syndrome; COVID-19; ACUTE LUNG INJURY; METAANALYSIS; SEPSIS; DRUG;
D O I
10.3390/ph16040631
中图分类号
R914 [药物化学];
学科分类号
100701 ;
摘要
COVID-19 is a fatal, fast-spreading pandemic, and numerous attempts are being made around the world to understand and manage the disease. COVID-19 patients may develop a cytokine-release syndrome, which causes serious respiratory diseases and, in many cases, death. The study examined the feasibility of employing legally available anti-inflammatory pentoxifylline (PTX), a low toxicity and cost medication, to mitigate the hyper-inflammation caused by COVID-19. Thirty adult patients who tested positive for SARS-CoV2 were hospitalized owing to the cytokine storm syndrome. They were given 400 mg of pentoxifylline orally TID according to the standard COVID-19 protocol of the Egyptian Ministry of Health. Besides this, a group of thirty-eight hospitalized COVID-19 patients who received the standard COVID-19 protocol was included in the study as a control group. The outcomes included laboratory test parameters, clinical improvements, and number of deaths in both groups. After receiving PTX, all patients showed a significant improvement in C reactive protein (CRP), and interleukin-6 (IL-6) levels at p < 0.01 and p = 0.004, respectively, while there was an increase in total leukocyte count (TLC) and neutrophil-to-leucocyte ratio (NLR) at p < 0.01 compared to their baseline levels. The D-dimer level showed a significant increase in the treatment group at p < 0.01, while showing no statistically significant difference in the control group. The median initial ALT (42 U/L) in the treatment group showed a decrease compared to the control group (51 U/L). No statistical significance was reported regarding clinical improvement, length of stay, and death percentages between the two groups. Our results showed no significant improvement of PTX over controls in clinical outcomes of hospitalized COVID-19 patients. Nevertheless, PTX displayed a positive effect on certain inflammatory biomarkers.
引用
收藏
页数:13
相关论文
共 51 条
[1]   Pentoxifylline effects on hospitalized patients with COVID19: A randomized, double-blind clinical trial [J].
Azizi, Hanieh ;
Rouhani, Nima ;
Shaki, Fatemeh ;
Karimpour-razkenari, Elahe ;
Ghazaeian, Monireh ;
Salehifar, Ebrahim ;
Saeedi, Majid ;
Fallah, Sahar .
INTERNATIONAL IMMUNOPHARMACOLOGY, 2021, 101
[2]  
Bermejo Martin Jesus Fco, 2003, Med Sci Monit, V9, pSR29
[3]   Effects of pentoxifylline on inflammatory markers and blood pressure: a systematic review and meta-analysis of randomized controlled trials [J].
Brie, Daniel ;
Sahebkar, Amirhossein ;
Penson, Peter E. ;
Dinca, Madalina ;
Ursoniu, Sorin ;
Serban, Maria-Corina ;
Zanchetti, Alberto ;
Howard, George ;
Ahmed, Ali ;
Aronow, Wilbert S. ;
Muntner, Paul ;
Lip, Gregory Y. H. ;
Wong, Nathan D. ;
Rysz, Jacek ;
Banach, Maciej .
JOURNAL OF HYPERTENSION, 2016, 34 (12) :2318-2329
[4]   Pentoxifylline in Heart Failure: A Meta-Analysis of Clinical Trials [J].
Champion, Sebastien ;
Lapidus, Nathanael ;
Cherie, Godefroy ;
Spagnoli, Vincent ;
Oliary, Juliette ;
Solal, Alain Cohen .
CARDIOVASCULAR THERAPEUTICS, 2014, 32 (04) :159-162
[5]   Antioxidants and pentoxifylline as coadjuvant measures to standard therapy to improve prognosis of patients with pneumonia by COVID-19 [J].
Chavarria, Adrian Palacios ;
Vazquez, Rafael Ricardo Valdez ;
Cherit, Jose Guillermo Dominguez ;
Bello, Hector Herrera ;
Suastegui, Humberto Castillejos ;
Moreno-Castaneda, Lidia ;
Estrada, Gabriela Alanis ;
Hernandez, Fabian ;
Gonzalez-Marcos, Omar ;
Saucedo-Orozco, Huitzilihuitl ;
Manzano-Pech, Linaloe ;
Marquez-Velasco, Ricardo ;
Guarner-Lans, Veronica ;
Perez-Torres, Israel ;
Soto, Maria Elena .
COMPUTATIONAL AND STRUCTURAL BIOTECHNOLOGY JOURNAL, 2021, 19 :1379-1390
[6]   Cytokine storm and sepsis disease pathogenesis [J].
Chousterman, Benjamin G. ;
Swirski, Filip K. ;
Weber, Georg F. .
SEMINARS IN IMMUNOPATHOLOGY, 2017, 39 (05) :517-528
[7]   Pentoxifylline: An Immunomodulatory Drug for the Treatment of COVID-19 [J].
Dhameliya, Hiren A. ;
Thakkar, Vasudev R. ;
Trivedi, Gauravi N. ;
Mesara, Sureshkumar N. ;
Subramanian, R. B. .
JOURNAL OF PURE AND APPLIED MICROBIOLOGY, 2020, 14 :861-867
[8]   Harnessing adenosine A2A receptors as a strategy for suppressing the lung inflammation and thrombotic complications of COVID-19: Potential of pentoxifylline and dipyridamole [J].
DiNicolantonio, James J. ;
Barroso-Aranda, Jorge .
MEDICAL HYPOTHESES, 2020, 143
[9]   Pentoxifylline exerts anti-inflammatory effects on cerebral ischemia reperfusion-induced injury in a rat model via the p38 mitogen-activated protein kinase signaling pathway [J].
Dong, Jianqing ;
Yuan, Xinmei ;
Xie, Weiwei .
MOLECULAR MEDICINE REPORTS, 2018, 17 (01) :1141-1147
[10]   Pentoxifylline as a Potential Adjuvant Therapy for COVID-19: Impeding the Burden of the Cytokine Storm [J].
Feret, Wiktoria ;
Nalewajska, Magdalena ;
Wojczynski, Lukasz ;
Witkiewicz, Wojciech ;
Klos, Patrycja ;
Dziedziejko, Violetta ;
Pawlik, Andrzej .
JOURNAL OF CLINICAL MEDICINE, 2021, 10 (22)