Approved MS medication inhibits SARS-CoV-2 replication in vitro

Dimethyl fumarate (DMF), a multiple sclerosis (MS) drug, inhibited SARS-CoV-2 replication and the hyper-inflammatory immune response associated with COVID-19.

red viruses pouring out of pink human cell

Across the globe, researchers are hoping to discover an antiviral medication that can both effectively inhibit SARS-CoV-2 replication and simultaneously combat the extreme immune reaction causing the death of COVID-19 patients around the world.

Now, investigators, led by Christian Kanstrup Holm and David Olagnier, have shown that dimethyl fumarate (DMF), a drug approved for the treatment of multiple sclerosis (MS), can inhibit the growth of a range of viruses in vitro, including the novel coronavirus – SARS-CoV-2.

“As we are doing basic research, we obviously do not know whether the drug works on infections in humans, and it is up to the infectious disease experts to test for this. However, I have to say that I am very optimistic,” said Holm, an associate professor at the Department of Biomedicine at Aarhus University, Denmark.

According to the researchers, when the COVID-19 pandemic – caused by the SARS-CoV-2 virus – struck they were already testing a similar MS medication, called 4-octyl-itaconate, for efficacy against herpes simplex virus, smallpox virus (vaccinia virus) and zika virus, as part of the hunt for a broad spectrum antiviral drug. Both 4-octyl-itaconate and DMF are NRF2 (nuclear factor erythroid-2-related factor 2) agonists – NRF2 is a transcription factor that activates the expression of over 500 genes, including an antioxidant gene expression pathway. 

When SARS-CoV-2 emerged, the team said they decided to expand their investigation to include it, with surprising results. According to Holm, when 4-octyl-itaconate was applied to SARS-CoV-2 infected cells it “drastically reduced” the number of viral replicas produced. “At the same time, the drug inhibited the immune reaction or inflammatory condition that constitutes a large portion of the actual threat for coronavirus patients. People do not just die of the virus, but also of the inflammation that occurs in the lungs,” he added.

After obtaining these results, the group decided to test a corresponding approved product, DMF, with virtually the same inhibitory effect. According to the team, the company that holds the patent for DMF are preparing to test the drug in human trials.

“You can really save a lot of time when you are testing a medication that has already been approved and tested in another context,” said Holm with reference to the statutory phases involved in getting a medication approved from scratch.

The study was published in Nature Communications.

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