NHS begins trial of stimulant that could improve blood flow in the lungs of Covid patients

A drug that could improve blood flow in the lungs of Covid patients will be trialled at NHS hospitals in Reading, Oxford and Cardiff to see if it can boost survival odds.  

Doctors led by Oxford University scientists will test how effective almitrine bismesylate, a lung stimulant, is at treating seriously ill Covid patients.

The 116-patient trial started this week at the Royal Berkshire Hospital in Reading and will be extended to John Radcliffe Hospital in Oxford and University Hospital of Wales in Cardiff over the next four months.

Patients who get very sick with coronavirus develop a condition called hypoxia, in which the levels of oxygen in the blood drop to dangerously low levels.

Not getting enough oxygen into the blood can, over extended periods of time, cause permanent organ damage that can ultimately be fatal.  

Researchers say this is because the virus prevents blood being diverted away from infected parts of the lungs to areas that still work properly, meaning blood is wasted in vessels where they can’t pick up any oxygen.

And they believe this pill, branded as Duxil but not currently on the market, could help reverse this problem by closing off those damaged parts of the lungs to make the blood’s oxygen uptake more efficient.

If the drug works it could be another breakthrough discovered on British soil, after researchers in the UK proved dexamethasone could cut Covid death rates.

Since that discovery last year, the wonder steroid has saved between 12,000 and 27,000 lives in Britain and 650,000 around the world, a study has estimated.

A drug that could help reduce the need for respirators in Covid treatment has begun testing in a clinical trial, University of Oxford researchers have announced. (Pictured: A Covid patient in intensive care in Spain)

The 116-patient trial started this week at the Royal Berkshire Hospital in Reading (pictured) and will be extended to John Radcliffe Hospital in Oxford and University Hospital of Wales in Cardiff over the next four months

Almitrine, which has been used in patients recovering from strokes in China, works by constricting the blood vessels in regions of the lung where the oxygen is low.

Oxygen gets into the blood when it is transferred from air pockets in the lungs.

This process happens in tiny blood vessels than run through the lungs and then take out the freshened blood into the heart to be pumped around the body.

If the lung tissue is infected – which may make it thicker with swelling or particularly wet if there is fluid build-up like in pneumonia – this process doesn’t work as well. As a result less oxygen gets through into the blood so there is less available to organs.

Almitrine works by minimising how much blood goes into these inefficient areas and diverting it to the healthier, functioning parts of the lungs. 

It has been successful in treating acute respiratory distress syndrome (ARDS), which causes inflammation in the lungs.

Researchers say almitrine could have the same effect in Covid patients, with the potential to help restore the natural protective process in the lungs and increase oxygen levels in arterial blood. 

Lead researcher Professor Peter Robbins, from the University of Oxford, said: ‘The primary idea behind medical treatment is that it is supportive – its aim is to keep people alive while they make their recovery from the disease. 

‘In a way, you can view the potential support from almitrine as extending people’s individual runway to make a recovery from the disease. 

‘The idea behind our trial is to enhance the supportive treatment – extend people’s runway.’

Almitrine will be given to patients over a seven-day period to determine whether it is effective in reducing the need for ventilators. 

Professor Robbins said: ‘I am pleased about our decision to use oral, rather than intravenous, almitrine for the trial. 

‘This lower tech approach could also be used in low- and middle-income countries which maybe have no, or insufficient, infrastructure to provide oxygen. 

‘As an oral drug, it really does have the potential to extend the runway to recovery for many people.’

The trial will examine the effect of the drug on two different groups. 

The first group will be made up of those who need breathing support and will measure the oxygen levels in their blood during treatment. 

The other group are those who do not require assisted breathing but will be monitored for whether or not the drug reduces the need for respiratory support. 

Nicky Lloyd, acting CEO of the Royal Berkshire NHS Foundation Trust, said: ‘This trial offers a great opportunity to supplement our increasing understanding of Covid-19 and meet the need for new, cost-effective treatments. 

‘The Royal Berkshire Hospital is a research-active hospital, which is well-placed to improve care and outcomes for our patients by taking part in collaborative research studies.’

Dr Nick Talbot, chief investigator for the overall trial across the three sites, added: ‘If almitrine proves beneficial for our patients, we think it would represent a really important new approach in the management of Covid-19.’