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Inhaler trialled in major Covid treatment study


By Isabel Shaw and Eleanor Philpotts

27 Nov 2020

An inhaler has been added to the list of commonly-used medications being investigated as a Covid-19 treatment that can be taken at home.

Researchers at Oxford University have added inhaled corticosteroid budesonide to the PRINCIPLE trial, a nationwide study testing the effectiveness of therapies available in primary care to potentially speed up the recovery of Covid patients and prevent hospital admission.

The trial is open to people who are aged over 50 living with comorbidities, and to anyone over the age of 65. Those with Covid-19 symptoms can join online from home or via GP practices across the country, without needing face-to-face consultations.

Budesonide is commonly prescribed for the long-term management of asthma and chronic obstructive pulmonary disease, and is described by the researchers as a safe and inexpensive inhaled corticosteroid, with no serious side-effects linked to short-term use

It is the fourth medication to be tested in the PRINCIPLE trial, joining antibiotics doxycycline and azithromycin. Hydroxychloroquine was suspended in June after researchers retracted a paper that had indicated the treatment was unsafe.

Minimising lung damage

Researchers believe that when inhaled, Budesonide can stop the Covid virus entering the lung cells, restrict damaging inflammation, and inhibit viral replication.

This is because some patients who contract Covid-19 mount a ‘significant’ immune response, which can lead to high levels of inflammation that can damage cells in the airways and lungs. Inhaling budesonide into the airways is said to target anti-inflammatory treatment where it is most needed, and potentially minimise lung damage that might have been caused otherwise.

Professor Chris Butler, trial lead, said: ‘Budesonide is a relatively inexpensive, safe and easy-to-administer drug for respiratory conditions that may have a role to play in treating Covid-19. It is

only through enrolling volunteers on a randomised controlled trial like PRINCIPLE that we can assess whether there are clear benefits or harms associated with potential treatments like budesonide.

‘We need many more volunteers to join the trial so we can get the answers we really need to keep people with Covid-19 out of the hospital. Like vaccines and preventative measures, treatments have an important role to play in minimising the burden of this disease on society.’

Earlier this month, LloydsPharmacy and Well Pharmacy joined the PRINCIPLE Trial to help find patients for the study. The partnerships mean posters signposting participants into the trial will be displayed in 2150 community pharmacies across the UK.


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