An oral drug may reduce the need for oxygen therapy and speed recovery of hospitalised COVID-19 patients.

Early findings from the ATTRACT study – a phase 2 led by an academic-pharma collaboration between Vicore Pharma and UCLH and UCL and part-funded by LifeArc – have led to a larger trial to evaluate the safety and efficacy of the new treatment in 600 patients. These encouraging, initial results were reported in EClinicalMedicine, published by The Lancet.

The new treatment, called Compound 21 (C21), is currently in development by Vicore as a possible treatment for a severe lung condition called idiopathic pulmonary fibrosis (IPF). It is a type of drug called an angiotensin II type 2 receptor (A2TR) agonist, which aims to improve lung function in patients with the condition.

Phase 2 findings pave the way for further trial

The ATTRACT (Angiotensin II Type Two Receptor Agonist COVID-19 Trial) phase 2 study evaluated whether C21 also had the potential to treat patients with COVID-19. It involved 106 COVID-19 patients receiving treatment at eight hospitals in India who had signs of acute respiratory infection but were not yet on a ventilator to receive additional oxygen to support their breathing. The study participants were randomly given either C21 twice daily for seven days, or a dummy pill (placebo), in addition to the usual standard care of treatment.

After 14 days from starting the treatment one of 51 (2%) patients in the C21 group required additional oxygen on a ventilator compared with 11 of 55 (20%) patients in the placebo group. These encouraging early results suggest that C21 may help to improve lung function in hospitalised patients with COVID-19. If the larger trial, called ATTRACT-III, confirms that C21 is beneficial for this group of patients, it could add to the range of medicines available for treating severe COVID-19. Results from the phase 3 study are expected in 2022.

Professor Jo Porter, consultant in respiratory and general medicine at UCLH and a professor in respiratory medicine at UCL, led the study. She said: “We saw a marked reduction in the need for oxygen at day 14 in patients who received C21, suggesting the treatment may help speed up recovery time for patients hospitalised with COVID-19. These phase 2 findings bode well for the phase 3 portion of the trial that will evaluate the efficacy and safety of C21 versus placebo, which is now under way.”

LifeArc’s wider funding for COVID-19

The ATTRACT study received £1.5 million in funding from LifeArc from our £10m drug repurposing call that was launched early in the pandemic. To date, LifeArc has provided more than £27 million to fund the search for new medicines and diagnostics to tackle COVID-19.

Dr Catriona Crombie, head of the LifeArc Philanthropic Fund, said: “Early in the pandemic we recognised that repurposed medicines offered the fastest route to patients help address COVID-19.

“We were excited by the promising results from this early-phase clinical trial, which has helped to identify a potential new drug that could help improve the outlook for seriously ill patients who are admitted into hospital with the disease.”

Dr. Rohit Batta, CMO of Vicore Pharma added:

“We are incredibly pleased to be able to share these results through a prestigious publication, and we are most thankful for the support from UCL and LifeArc.”

Find out more about how LifeArc is addressing the COVID-19 challenge.