Fenofibrate: A Potential Tool Against COVID-19

Study Findings on Fenofibrate

Recent research suggests that fenofibrate, an established medication, may reduce COVID-19 (SARS-CoV-2) infections by as much as 70%. Originally approved by the FDA in 1993, fenofibrate is primarily used to lower LDL cholesterol levels by converting to fenofibric acid in the body. Its potential effectiveness against COVID-19 could enhance the arsenal of treatments available for the virus.

Importance for Vulnerable Populations

The study, published in *Frontiers in Pharmacology*, emphasizes the significance of fenofibrate for individuals who cannot receive COVID-19 vaccinations, as well as for those hospitalized with severe variants of the virus. While vaccination rates continue to rise, concerns remain about the duration and strength of immunity. The availability of fenofibrate could provide an additional option for symptomatic patients and help curb infection spread.

Co-author Dr. Alan Richardson noted, “Whilst vaccination has been shown to reduce infection rates and severity of disease, we are as yet unsure of the strength and duration of the response. Therapies are still urgently needed to manage COVID-19 patients who develop symptoms or require hospitalization.”

Mechanism of Action

Fenofibrate works by hindering the interaction between the COVID-19 virus and human cells. The virus features a spike protein with a receptor binding domain (RBD) that attaches to the human angiotensin-converting enzyme 2 (ACE2), enabling viral entry into cells. Fenofibric acid, a metabolite of fenofibrate, was found to diminish this interaction and destabilize the spike protein’s RBD. These findings indicate that fenofibrate could play a role in controlling COVID-19 infections.

Impact on Infection Rates

The study assessed the effects of fenofibrate and fenofibric acid on COVID-19 infection rates at 24 and 48 hours post-exposure. The 24-hour period represented the initial infection response, while the 48-hour mark examined the secondary response from newly produced viral particles. For the strain of COVID-19 from England, there was a 60% reduction in cell infection at 24 hours, with similar decreases at the 48-hour mark. The strain from Italy also showed significant reductions in infection following treatment with fenofibric acid. Importantly, the concentrations used were achievable in clinical settings, suggesting potential for human treatment.

Need for Clinical Trials

Fenofibrate is generally regarded as safe and has been proposed as a treatment for COVID-19 in prior studies. Co-author Dr. Elisa Vicenzi remarked, “Given that fenofibrate is an oral drug which is very cheap and available worldwide, combined with its extensive history of clinical use and good safety profile, our data has global implications—especially in low-middle-income countries and among individuals for whom vaccines are not recommended or suitable, such as children, those with hyper-immune disorders, and those on immune-suppressants.”

However, the use of fenofibrate for COVID-19 carries risks, including possible drug-drug interactions. The researchers recommend testing fenofibrate in symptomatic, non-hospitalized COVID-19 patients to evaluate its efficacy in reducing symptom severity and infection spread.

References

1. Davies, S.P. et al. (2021). The Hyperlipidaemic Drug Fenofibrate Significantly Reduces Infection by SARS-CoV-2 in Cell Culture Models. *Frontiers in Pharmacology*. Doi: 10.3389/fphar.2021.660490.
2. Downing, N.S. et al. (2013). How Abbott’s Fenofibrate Franchise Avoided Generic Competition. *Archives of Internal Medicine*; 172(9): 724-730. Doi: 10.1001/archinternmed.2012.187.
3. “Licensed drug could reduce SARS-CoV-2 infection by up to 70 per cent, reveals study.” (2021). *EurekAlert!* Accessed on August 14, 2021. Retrieved from https://www.eurekalert.org/news-releases/924448.
4. Clausen, T. M. et al. (2020). SARS-CoV-2 Infection Depends on Cellular Heparan Sulfate and ACE2. *Cell*; 183(4), 1043–e15. doi:10.1016/j.cell.2020.09.033.
5. Hoffmann, M. et al. (2020). SARS-CoV-2 Cell Entry Depends on ACE2 and TMPRSS2 and Is Blocked by a Clinically Proven Protease Inhibitor. *Cell*; 181(2), 271–e8. doi:10.1016/j.cell.2020.02.052.
6. Yan, R. et al. (2020). Structural Basis for the Recognition of SARS-CoV-2 by Full-Length Human ACE2. *Science*; 367 (6485), 1444–1448. doi:10.1126/science.abb2762.
7. Buschard, K. (2020). Fenofibrate Increases the Amount of Sulfatide Which Seems Beneficial against Covid-19. *Medical Hypotheses*; 143: 110127. doi:10.1016/j.mehy.2020.110127.
8. Image by Miguel Á. Padriñán from Pixabay.