Table 1.
Drugs targeting lipid pathways currently in clinical trials for COVID-19
| Drug(s) | Target | Rationale for Use in COVID-19 | ClinicalTrials.gov Identifier/Reference |
|---|---|---|---|
| Ibuprofen | COX-1 and COX-2 | COX-2 inhibition is anti-inflammatory and improves survival in preclinical models of viral infection. Inhibition of PGE2 synthesis enhances the type I interferon response to viral infection. |
NCT04334629, NCT04382768 |
| Celecoxib | COX-2 | COX-2 inhibition is anti-inflammatory and improves survival in preclinical models of viral infection. Inhibition of PGE2 synthesis enhances the type I interferon response to viral infection. |
NCT04488081 |
| Low-dose aspirin | Platelet COX-1 | Inhibition of TxA2 synthesis decreases platelet aggregation, which may prevent thrombotic complications of COVID-19. | NCT04365309, NCT02735707, NCT04703608, NCT04483960, NCT04333407, NCT04324463, NCT04381936, NCT04498273, NCT04368377, NCT04363840, NCT04466670, NCT04808895, NCT04937088, NCT04768179, NCT04410328 |
| Epoprostenol and iloprost | IPr | Prostacyclin analogs promote vasodilation in the pulmonary vasculature, which improve inflammation and oxygenation in COVID-19 patients with ARDS. | NCT04705597, NCT04420741, NCT04445246 |
| BGE-175 | DPr1 | Inhibition of DPr1 signaling enhances the adaptive immune response to viral infection in preclinical models. | NCT04705597 |
| Montelukast and Zafirlukast | CysLT1R | CysLT1R inhibition is anti-inflammatory and decreases airway hyper-responsiveness after pulmonary viral infection. | NCT04871828, NCT04718285, NCT04695704, NCT04389411, NCT04714515 |
| EPA, DHA, and icosapent ethyl | N/A | Omega-3 fatty acids have anti-inflammatory effects. | NCT04505098, NCT04412018, NCT04460651, NCT04957940, NCT04658433, NCT04495816, NCT04647604, NCT04483271; Arnardottir et al. (88) |
| Statins | HMG-CoA Reductase | Inhibition of cholesterol synthesis may deplete cholesterol in lipid rafts. Statins have pleiotropic anti-inflammatory effects and have been associated with improved outcomes in patients with viral pneumonia. |
NCT04472611, NCT04904536, NCT04359095, NCT04801940, NCT04380402, NCT04466241, NCT04952350, NCT04900155, NCT02735707, NCT04333407 |
| Fenofibrate | PPAR-α | PPAR-α agonism may reverse alterations in lipid metabolism induced by SARS-CoV-2 and block viral replication. | NCT04517396, NCT04661930 |
| Evolocumab | PCSK9 | PCSK9 loss-of-function genetic variants have been associated with a decrease in inflammatory cytokine response and improved survival in septic shock patients. | NCT04941105 |
| Opaganib | SK2 | SK inhibition suppresses viral replication and inhibits the hyperinflammatory response to viral infection. | NCT04467840, NCT04414618 |
| Ozanimod | S1P1 and S1P5 | Activation of S1P signaling restrained cytokine storm, reduced lung pathology, and improved survival in preclinical models of viral infection. | NCT04405102 |