Breakthrough for PH Covid-19 cure

THE Filipino- developed formulation set to undergo clinical trials as a cure for coronavirus disease 2019 ( Covid- 19) has gotten a boost from British researchers and the World Health Organization ( WHO).

As a University of Oxford press release reported on Tuesday, the steroid dexamethasone, one of two components of the Philippine formulation, prevented about one- third of deaths among seriously ill patients dependent on ventilators. And among those just requiring oxygen, another 1 in every 5 recovered in massive trials covering 11,500 patients in more than 175 public hospitals in the United Kingdom

“This is the first treatment to be shown to reduce mortality in patients with Covid-19 requiring oxygen or ventilator support,” declared WHO Director-General Dr. Tedros Adhanom Ghebreyesus. “This is great news, and I congratulate the government of the UK, the University of Oxford, and the many hospitals and patients in the UK who have contributed to this lifesaving scientific breakthrough.”

The results announced this week by the UK research group Recovery gives scientific basis for the Philippines’ own medication combining dexamethasone with the anesthetic procaine.

First used decades ago against snake venom by Filipino- American Dr. Ruben Fabunan, the combination drug was also reported to be successful against killer viral ailments like dengue, leptospirosis, chikungunya and acquired immune deficiency syndrome ( AIDS). Plus, dexamethasoneprocaine is said to have cured at least one patient tested positive for Covid- 19 as well as others with symptoms of the disease.

The struggle for clinical trials

Advocate Ruby Ann Kagaoan, a close friend of this writer, began pushing for clinical trials for dexamethasone- procaine soon after Metro Manila locked down in mid- March. There were initial difficulties, including a March 30 warning from the Food and Drug Administration ( FDA) over the dexamethasone and procaine ingredients.

Things began to look up in early April. Department of Science and Technology ( DoST) Secretary Fortunato de la Peña, whom this former Cabinet secretary met during the Arroyo administration, asked the Philippine Council for Health Research and Development ( PCHRD) to help.

PCHRD head Dr. Jaime Montoya then sounded out several research entities; he got a nod from the Philippine College of Physicians ( PCP) and the University of the Philippines ( UP) College of Pharmacy. But false patent claims over dexamethasoneprocaine raised concerns, prompting the PCP to withdraw.

The controversy fueled by online videos and posts also saw a Facebook Messenger threat to baselessly sue Kagaoan for arranging clinical trials. That led her Covid- 19 Cure Team to seek help from top patent lawyer Rico Domingo, first vice president of the Philippine Bar Association. He immediately promised assistance and reassured the research group that there were no patent issues, since no less than the Bureau of Patents of the Intellectual Property Office ( IPO) informed Kagaoan there are no patents in force over dexamethasoneprocaine (https://www. manilatimes.net/2020/05/17/ opinion/columnists/topanalysis/ 19-cure-trials/725343/).

Thankfully, after the PCP pulled out, the De La Salle Medical and Health Sciences

Institute ( DLSMHSI), contacted by Kagaoan through De La Salle University ( DLSU) Professor Ruth Rozul, took its place in the research, with full support from former Education secretary and DLSU president Brother Armin Luistro.

Led by Drs. Charles Yu and Jovilia Abong, and pharmacy dean Alice Catabay, DLSMHSI has since met with the UP College of Pharmacy, represented by pharmaceutical chemistry department chairman Joanna Toralba. With DoST funding, the first phase of “in vitro” laboratory trials will test dexamethasone- procaine against severe acute respiratory syndrome coronavirus 2 ( SARSCov2), the Covid- 19 microbe. This is to transpire in Singapore, due to the heavy workload at the Research Institute for Tropical Medicine ( RITM), the only lab in the country able to work on live viruses.

In a 2011 in vitro study at the University of North Carolina at Greensboro ( UNCG), the drug combination greatly reduced viral activity and killed the human immunodeficiency virus ( HIV), which causes AIDS. A 2018 commissioned study by the St. Luke’s Medical Center Molecular Immunology Laboratory saw similar success against dengue serotype 2 viruses. If effective in the lab in the current study, the formulation, once optimized against SARS- Cov2, would proceed to “in vivo” clinical trials with volunteer patients.

Race to our own Covid-19 cure

Long before this week’s UK research came to light, Dr. Montoya of PCHRD and Dr. Yu of DLSMHSI saw dexamethasone as helping Covid- 19 patients by alleviating inflammation in the lungs, which constricts breathing, leading to death. The combination with the pain- suppressing anesthetic procaine may also reduce lifethreatening swelling, since pain causes immunity- weakening stress and prods the body to rush healing cells and substances to the affected area, probably aggravating congestion.

This anti- inflammatory effect may further combine with dexamethasone- procaine’s antiviral properties. In the UNCG study, the formulation was found to have killed as much as half of HIV- infected cells compared with control samples not infused with the drug. The combination was also shown to significantly reduce HIV replication, even with viruses that were resistant to the HIV- AIDS drug azidothymidine ( AZT).

In sum, the Philippines’ dexamethasone- procaine formulation may well prove more effective against Covid- 19 than dexamethasone alone. That, of course, must still be proven in clinical trials. Hence, the imperative for the government, hospitals, physicians, and patients to join hands with the DoST, PCHRD, UP College of Pharmacy and DLSMHSI in accelerating the formulation, dose- ranging and clinical testing of the Filipino- developed possible Covid- 19 cure.

If dexamethasone- procaine proves effective, then the country will not have to depend on foreign remedies in the battle against Covid- 19. Rapid healing would also decongest hospitals and enable further loosening of lockdown and economic recovery, confident that any rise in infections would not overwhelm medical facilities, since the Philippine drug would heal patients fast, reducing hospital confinement and congestion.

The Covid-19 Cure Team and its research partners take heart from the UK findings on dexamethasone. Now, it is high time our own nation, government and medical professionals and establishment give the country’s homegrown remedy the scientific testing it needs and deserves. Then dexamethasone- procaine may well become not just a lifesaver, but our country’s singular contribution to the global battle against the pandemic disease and economic depression.