In a controlled laboratory test, Eagle Pharmaceuticals’
malignant hyperthermia treatment Ryanodex (dantrolene sodium) inhibited
the growth of SARS-CoV-2, the virus causing the COVID-19 pandemic. Now
the company hopes to launch a clinical trial testing the efficacy of the
drug in patients.
In the in vitro tests, Ryanodex demonstrated antiviral activity
and a lack of cytotoxicity. Two days after dosing, the in vitro results
showed an absence of cytopathic effects in the infected cells. This
morning, New Jersey-based Eagle Pharmaceutical submitted its
Investigational New Drug Application to the U.S. Food and Drug
Administration to launch a Phase II trial in partnership with Hackensack
University Medical Center to evaluate the efficacy of Ryanodex in
patients infected with SARS-CoV-2. The company said it has been in
contact with the FDA’s Coronavirus Treatment Acceleration Program to
request a potential expedited review of the IND application and aims to
begin the clinical trial as soon as possible.
Ryanodex acts by modulating free intracellular calcium levels to
restore calcium homeostatic balance inside cells. Eagle is exploring the
relationship between viral infection and the regulation of calcium
levels inside cells. Depending on the virus type, an altered
intracellular calcium balance may enhance virus entry, replication and
release, the company said. As a result, intracellular calcium levels may
be an important factor in viral-host interactions and viral infections,
Eagle noted in its announcement.
Eagle said the Phase II trial will use the World Health Organization
Ordinal Scale of Severity, the Sequential Organ Failure Assessment and
other relevant clinical measurements will be used as efficacy endpoints.
The trial will enroll approximately 60 adult COVID-19 patients with
confirmed SARS-CoV-2 infection. The company anticipates results from the
trial in May if the FDA gives it the green light.
“The results of Eagle Pharmaceuticals’ virus neutralization assay
demonstrated a lack of viral growth in Ryanodex-treated cells compared
to those not treated with Ryanodex. This outcome suggests that Ryanodex
may have antiviral activity against SARS-CoV-2, which we believe
represents a novel approach to impeding the virus lifecycle by
modulating free intracellular calcium levels of host cells,” Adrian
Hepner, chief medical officer of Eagle Pharmaceuticals said in a
statement. “We now plan to conduct a clinical trial in partnership with
Hackensack University Medical Center to evaluate the efficacy and safety
of RYANODEX as a potential treatment for patients hospitalized with
COVID-19.”
In its announcement this morning, Eagle said it is increasing
production of Ryanodex, which was initially approved by the FDA in 2014
for the life-threatening malignant hyperthermia, in advance of clinical
trials and to potentially shorten the supply chain lead time if
necessary. To support this, Eagle forged a strategic manufacturing
partnership with Amneal Pharmaceuticals, Inc. Eagle is also working with
its existing manufacturing partner, Durham, N.C.-based Alcami
Corporation to increase the production of the drug.
https://www.biospace.com/article/eagle-pharmaceuticals-plans-to-aim-ryanodex-at-covid-19-in-phase-ii-trial/
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