Conestat alfa in the treatment of COVID-19

Exaggerated inflammatory reaction seems to be the main driver of COVID-19 disease progression up to and including lung failure. Conestat alfa is a man-made form of a protein that occurs naturally in the bloodstream and which blocks several of the inflammatory systems involved in COVID-19-related exaggerated inflammation. An animal study of the protein in coronavirus has already produced promising results.

The PROTECT-COVID-19 trial will investigate whether conestat alfa can prevent severe disease progression and the need for mechanical ventilation in hospitalised patients with COVID-19. In addition to efficacy and tolerability, the trial will also assess the level of inflammation in the four-week period following enrolment.

The trial will take place at University Hospital Basel, Triemli Hospital (Zurich) and St. Gallen Cantonal Hospital in Switzerland and at two hospitals in Brazil and Mexico. Around 120 patients with COVID-19 and pneumonia will be randomly assigned to two groups, only one of which will receive conestat alfa in addition to standard-of-care treatment. It is hoped that conestat alfa will prevent progression of the inflammatory reaction and the need for mechanical ventilation by blockading several inflammatory systems. The findings could be useful for future viral pandemics.

Medicines that prevent COVID-19-induced lung failure could play an important role in treating patients with the disease. Should conestat alfa prove to be effective in this context, it would reduce the need for treatment in intensive care units and mechanical ventilation. This would not only benefit each individual with the disease, but represent a benefit to society, given the limited number of ventilators.

Recombinant human C1 esterase inhibitor (conestat alfa) in the prevention of critical SARS-CoV-2 infection in hospitalized patients with COVID-19: a randomized, parallel-group, openlabel, multi-center exploratory trial.