An inhaled steroid will be investigated as a possible treatment for coronavirus as part of a nationwide trial.
Budesonide will be part of the UK priority platform trial for Covid-19 treatments that can be taken at home.
Led by the University of Oxford, the Principle (Platform Randomized trial of INterventions against Covid-19 In senior peoPLE) study is evaluating treatments that can help people over 50 recover faster from the coronavirus and avoid the need for hospitalization.
Inhaled corticosteroid budesonide is often prescribed as part of the long-term treatment of asthma and chronic obstructive pulmonary disease without serious side effects with short-term use.
In some patients with Covid-19, the body builds up a significant immune response to fight the virus, causing high levels of inflammation that can damage human cells in the airways and lungs.
Research suggests that breathing budesonide into the airways targets anti-inflammatory treatments where it is most needed and could potentially minimize any lung damage that would otherwise be caused by the virus.
Sars-CoV-2, the virus that causes Covid-19, binds to ACE2 receptors that line the cells in the airways, access human cells, and replicate within.
Laboratory studies suggest that inhaled corticosteroids reduce the number of these receptors in the airways and thus may block the virus’ access to human cells.
Professor Chris Butler of the University of Oxford, who led the Principle study, said: “Budesonide is a relatively inexpensive, safe and easy to administer drug for respiratory diseases that may play a role in the treatment of Covid-19.
Only by enrolling volunteers in a randomized controlled trial such as Principle can we assess whether there are clear benefits or drawbacks associated with potential treatments such as budesonide.
“We need a lot more volunteers to participate in the study so we can get the answers we really need to keep people with Covid-19 out of the hospital.
“Like vaccines and preventive measures, treatments play an important role in minimizing the burden of this disease on society.”
Study participants will be randomly assigned to receive an inhaler by mail and the usual standard of care from their physician.
They will be asked to inhale two puffs twice a day for 14 days, each puff yielding a dose of 400 micrograms of budesonide.
They are followed up for 28 days and compared with participants assigned to receive usual standard care only.