Open Study to Investigate the Efficacy of Abrocitinib in Adult Participants with Severe Fatigue from Post COVID Condition/Long COVID (CLEAR-LC)
- Thread starter Jaybee00
- Start date
-
- Tags
- abrocitinib
Murph
Senior Member (Voting Rights)
You love to see drugs getting tested, even when the cohort definition is a bit iffy.
This one seems to have come out of left field.
I looked through the clinical trial data and it wasn't obvious who the researcher behind this is. The only name I found was this guy who is the boss of virology at Beth Israel and has quite a nice CV. I'd imagine he's the ultimate responsible party but not actually driving it.
https://en.wikipedia.org/wiki/Dan_Barouch
Anyway Abrocitinib is a JAK inhibitor, widely available from Pfizer and usually used for tricky cases of dermatitis.
It is a selective inhibitor of the enzyme janus kinase 1 (JAK1).[15] It inhibits JAK1 by 28 fold of selectivity over JAK2 and more than 340 fold of selectivity over JAK3. Two mechanisms are involved in atopic dermatitis, one involves epidermal barrier disruptions, and the other one is cutaneous inflammation due to the immune system over response. Acute inflammation in AD typically involves IL-13, IL-4, and IL-33.[17] Consequently, inhibiting JAK1 results in suppressing the signaling cytokines IL-4, IL-3, and IL-31. Many other cytokines are involved in AD and mediated by JAK1 such as type II cytokine receptors for IL-22, IL-19, IL-10, IL-20 and glycoprotein 130 (gp130) including IL-6 and IL-12 which are also associated with JAK2 and TYK2; IFN-α and INF-β signal.[17][18]
Pharmacokinetics
Abrocitinib is quickly absorbed from the gut and generally reaches highest blood plasma concentrations within one hour. Only 1.0 to 4.4% of the dose are found unmetabolized in the urine.[19] The half-life of abrocitinib is 5 hours and the absorption is not affected by food. A higher dose (400–800 mg) would delay the absorption to 1.5–4 hours. A steady plasma concentration of abrocitinib can be obtained within 48 hours of treatments.[17][18] The dose is one daily, and abrocitinib is metabolized mainly by cytochrome P450 (CYP450) in liver such as CYP2C9, CYP2C19, CYP3A4 and CYP2B6. The major metabolites of abrocitinib are pyrrolidinone pyrimidine (inactive), 2-hydroxypropyl (active), and 3-hydroxypropyl (active).[17][18] Dose reduction to half is advisable when abrocitinib is taken with strong inhibitors of CYP2C19. According to phase 1 clinical trials on abrocitinib oral dose of 200 mg, hepatic functions were not altered. However, it is advisable to reduce the dose by half in case of reduced renal function. In serious hepatic impairment and final stages of renal disease, Abrocitinib is contraindicated.[17] Some changes may occur during the abrocitinib treatment such as the reduction in platelet counts after 4 weeks of starting Abrocitinib. However, they will return to normal at the end of the treatment. An increase in LDL, HDL, and total cholesterol levels was also recorded after 4 weeks of Abrocitinib treatment. The increased levels depend on the abrocitinib dose (15% increase in LDL with 200 mg dose versus 10% increase with 100 mg).[17][18]
This one seems to have come out of left field.
I looked through the clinical trial data and it wasn't obvious who the researcher behind this is. The only name I found was this guy who is the boss of virology at Beth Israel and has quite a nice CV. I'd imagine he's the ultimate responsible party but not actually driving it.
https://en.wikipedia.org/wiki/Dan_Barouch
Anyway Abrocitinib is a JAK inhibitor, widely available from Pfizer and usually used for tricky cases of dermatitis.
It is a selective inhibitor of the enzyme janus kinase 1 (JAK1).[15] It inhibits JAK1 by 28 fold of selectivity over JAK2 and more than 340 fold of selectivity over JAK3. Two mechanisms are involved in atopic dermatitis, one involves epidermal barrier disruptions, and the other one is cutaneous inflammation due to the immune system over response. Acute inflammation in AD typically involves IL-13, IL-4, and IL-33.[17] Consequently, inhibiting JAK1 results in suppressing the signaling cytokines IL-4, IL-3, and IL-31. Many other cytokines are involved in AD and mediated by JAK1 such as type II cytokine receptors for IL-22, IL-19, IL-10, IL-20 and glycoprotein 130 (gp130) including IL-6 and IL-12 which are also associated with JAK2 and TYK2; IFN-α and INF-β signal.[17][18]
Pharmacokinetics
Abrocitinib is quickly absorbed from the gut and generally reaches highest blood plasma concentrations within one hour. Only 1.0 to 4.4% of the dose are found unmetabolized in the urine.[19] The half-life of abrocitinib is 5 hours and the absorption is not affected by food. A higher dose (400–800 mg) would delay the absorption to 1.5–4 hours. A steady plasma concentration of abrocitinib can be obtained within 48 hours of treatments.[17][18] The dose is one daily, and abrocitinib is metabolized mainly by cytochrome P450 (CYP450) in liver such as CYP2C9, CYP2C19, CYP3A4 and CYP2B6. The major metabolites of abrocitinib are pyrrolidinone pyrimidine (inactive), 2-hydroxypropyl (active), and 3-hydroxypropyl (active).[17][18] Dose reduction to half is advisable when abrocitinib is taken with strong inhibitors of CYP2C19. According to phase 1 clinical trials on abrocitinib oral dose of 200 mg, hepatic functions were not altered. However, it is advisable to reduce the dose by half in case of reduced renal function. In serious hepatic impairment and final stages of renal disease, Abrocitinib is contraindicated.[17] Some changes may occur during the abrocitinib treatment such as the reduction in platelet counts after 4 weeks of starting Abrocitinib. However, they will return to normal at the end of the treatment. An increase in LDL, HDL, and total cholesterol levels was also recorded after 4 weeks of Abrocitinib treatment. The increased levels depend on the abrocitinib dose (15% increase in LDL with 200 mg dose versus 10% increase with 100 mg).[17][18]
Last edited by a moderator:
Covidivici
Established Member (Voting Rights)
Piggybacking this thread upon reading a study out of Harvard, published in Nature Immunology today:
In the discussion section, the authors note:
They also conclude:
The study:
The trial:
Long COVID involves activation of proinflammatory and immune exhaustion pathways
In the discussion section, the authors note:
They also conclude:
The study:
The trial:
