New Delhi: Indomethacin, an arthritis and antiviral drug patented in 1965, could be a safe and effective treatment for mild and moderate cases of Covid-19, according to a study by researchers from IIT Madras and Panimalar Medical College Hospital & Research Institute in Chennai.
Published Tuesday in the journal Scientific Reports, the study shows that Covid-19 patients administered a five-day course of Indomethacin were less likely to require oxygen therapy, and more likely to recover faster.
The researchers have written to the health ministry about their findings, and are hopeful that the drug will be included in India’s Covid treatment protocol.
The study’s primary aim was to determine the efficacy of indomethacin in preventing a drop in oxygen levels, and deterioration in mild and moderate cases of Covid-19.
In a randomised clinical trial, 210 patients were divided into two groups. While the first group of 107 participants received paracetamol, the rest were administered indomethacin.
Recovery period halved
It was found that nearly 50 per cent of patients in the indomethacin group had fully recovered within fourteen days, compared to patients in the paracetamol group who took 28 days to recover from Covid-19.
The study also found that while 20 patients in the paracetamol group developed oxygen desaturation, none of the patients in the indomethacin group faced this condition. Researchers noted that oxygen levels of Covid-19 patients improved after one or two doses of indomethacin.
Fever subsided within three days among patients who received indomethacin, compared to seven days for those who received paracetamol. Similarly, the former recovered from coughs in four days, compared to seven days for the latter.
Only nine out of 70 patients in the indomethacin group took seven days or more to recover. It was further noted that no patient in this group required continued doses of indomethacin after the initial five-day regimen, according to the researchers.
‘Safe and well-understood drug’
Indomethacin has been used widely since the 1960s to treat various types of inflammation-related diseases such as arthritis.
“Knowing that one of the deadly effects of the Covid infection is inflammation and the cytokine storm, we decided to study the non‐steroidal anti‐inflammatory drug, indomethacin,” said Rajan Ravichandran, an adjunct faculty at IIT Madras and director (Nephrology) at MIOT hospitals, where the clinical trials were conducted.
“The scientific evidence strongly shows the antiviral action against the coronavirus. indomethacin is a safe and well-understood drug. I have been using it in my profession for the past 30 years,” he added.
Addressing a virtual press briefing, Ravichandran said that the researchers have written to the health ministry and the Indian Council of Medical Research (ICMR) about their findings, and are hopeful that the drug will be added to India’s Covid treatment protocol.
Ravichandran explained to ThePrint that corticosteroids — which have been approved for Covid treatment — dampen the body’s immune system, making it vulnerable to further infections such as black fungus.
“On the other hand, indomethacin only has some short-term adverse effects like stomach ache due to acidity. That, too, can be tackled with antacids,” Ravichandran said.
According to the researchers, the drug is cheaper than monoclonal antibody treatments.
Ravichandran added that since the drug is well known and low cost, pharmaceutical companies are not pushing for it to be included in the Covid-19 treatment protocols.
Findings back results of earlier study
The findings of the trial support an earlier study by the same team that was published in the Journal of the Indian Medical Association.
In the earlier study, 72 patients were administered indomethacin and 72 other patients, paracetamol.
This study also showed that only one patient treated with indomethacin developed hypoxia, compared to 28 in the paracetamol group. Furthermore, it was found that the administration of indomethacin to patients exhibiting severe Covid symptoms prevented the need for ventilation.
“Indomethacin works with all variants. We had done two trials, one in the first wave and the other in the second wave. The results were the same. I sincerely hope ICMR takes note of this study and includes indomethacin in COVID treatment protocol,” Ravichandran said.
(Edited by Amrtansh Arora)