Researchers from Aarhus University Hospital and Aarhus University have tested whether a Japanese medication against heartburn can be used to treat the new coronavirus. However, the researchers have not been able to demonstrate any effect on COVID-19, although the testing of the drug camostat mesilate will continue with a higher dose elsewhere in Europe.

2021.04.27 | Helle Horskjær Hansen

Ole Schmeltz Søgaard and Mads Fuglsang Kjølby. Photo: Tonny Foghmar.

Over the last year, researchers have investigated whether camostat mesilate – an old Japanese medication against heartburn and inflammation of the pancreas – can slow down Covid-19.

And although heartburn and Covid-19 may appear to have as little in common as toothache and verrucas, there is nevertheless logic in looking closer at camostat mesilate as a possible weapon in the fight against Covid-19, explains Mads Fuglsang Kjølby, one of the researchers behind the project.

"The idea arose in March 2020 when we read a scientific article in which it was demonstrated that camostat mesilate can curb a so-called old variant of the coronavirus. This is the variant which back in 2002-03 led to SARS in many countries. And because this old variant is closely related to SARS-CoV-2 – the coronavirus, which is the very cause of Covid-19 – it seemed obvious to take a closer look at camostat mesilate. It could be that the drug also inhibits Covid-19."

No effect – higher dose tested

The trial has now been completed, and the results have just been published in the scientific journal EClinicalMedicine, which is published by The Lancet.

A total of 205 patients took part in the trial, and the researchers cannot with statistical certainty demonstrate any positive effect of camostat mesilate in terms of slowing down Covid-19.

The drug did not shorten the patients' hospitalisation time, nor did it have any effect on the severity of the disease.

However, camostat mesilate has not been discarded in the fight against Covid-19. This is according to another of the researchers behind the study, Ole Schmeltz Søgaard. 

"The dose we used in our trial may have been too low. Therefore, a German and a Japanese trial have begun testing the drug against Covid-19 using a far higher dose. And many of us are anxiously awaiting for the results of these trials."

In the trial, 600 milligrams of camostat mesilate was administered to hospitalised patients over a 24-hour period for five consecutive days. However, this dose can be increased significantly, "says Mads Fuglsang Kjølby:

“Camostat mesilate has been tested by the Japanese pharmaceutical agencies, who are known for being very scrupulous and often have requirements that are at least as strict as the authorities in Europe and USA. In the new trial, the daily dose is between 1,800 and 2,400 milligrams."

Can act quickly

Should the researchers discover that camostat mesilate can inhibit Covid-19, it would be possible to put the drug on the market very quickly, according to Mads Fuglsang Kjølby.

The two researchers are currently testing camostat mesilate on outpatients with Covid-19 in Denmark. That is to say people who have been tested positively, but who are not so ill that they need hospitalisation.

"The question is whether this group of patients could benefit from the Japanese heartburn drug earlier in the course of their disease – that is, whether the drug appears to reduce the consequences of Covid-19. But this study is currently underway, so we don't have any results yet," says Ole Schmeltz Søgaard.

Background for the results

• The study is an international double-blind, randomised, placebo-controlled clinical trial. Several hospitals in all five Danish regions and a hospital in Sweden have participated in the trial. The study is financed by the Lundbeck Foundation.
• The scientific article can be read in EClinicalMedicine.

Contact 

Associate Professor Mads Fuglsang Kjølby
Aarhus University, Department of Biomedicine
mads@dandrite.au.dk
Mobile: (+45) 6086 6653

Professor Ole Schmeltz Søgaard
Aarhus University, Department of Clinical Medicine and
Aarhus University Hospital, Department of Infectious Diseases
olesoega@rm.dk
Mobile: (+45) 2721 5985