A new clinical study has found that asunercept, a drug that inhibits Fas ligand (FasL), can speed up recovery and reduce mortality in COVID-19 patients. The study, published in eClinicalMedicine, shows that patients treated with asunercept recovered in an average of eight days, compared to 13 days for those receiving standard care. Additionally, mortality was reduced by about 20%. The study, titled “Efficacy and safety of asunercept, a CD95L-selective inhibitor, in hospitalized patients with moderate-to-severe COVID-19: ASUNCTIS,” was a multicenter, randomized, open-label, phase 2 trial.
FasL plays a key role in regulating the immune system by controlling T cells, a type of white blood cell. In severe COVID-19 cases, however, the immune system becomes overactive, leading to an excess of FasL. This overproduction results in excessive T cell death and damage to normal lung cells, contributing to conditions like lymphopenia (a loss of lymphocytes) and severe lung inflammation—two major complications in COVID-19. By inhibiting FasL, asunercept aims to prevent this damage and reduce inflammation.
The research team had previously shown in animal studies that inhibiting FasL improved survival in mice with severe COVID-19. This led to the clinical trial, which was initiated through a collaboration between Professor Henning Walczak and his team at the University of Cologne and University College London (UCL), Professor Michael Bergmann at the Medical University of Vienna, and Dr. Thomas Hoeger at Apogenix GmbH, a biotech company in Heidelberg, Germany. The trial took place across ten centers in Spain and Russia from October 2020 to December 2021, involving 438 patients.
The patients were divided into four groups. All participants received standard care, while three groups received different doses of asunercept (25 mg, 100 mg, and 400 mg per week). The 100 mg and 400 mg doses showed the most promise, with patients recovering in about eight days on average, compared to the 13 days it took the control group. A post-hoc analysis combining all three asunercept dose groups revealed a significant benefit, with patients recovering five days faster on average than those in the control group.
The higher doses (100 mg and 400 mg) were also linked to a 20% reduction in mortality. Overall, the study concluded that asunercept was safe and well-tolerated by patients, with strong evidence suggesting its potential to shorten recovery times in severe COVID-19 cases.
Michael Bergmann, one of the study’s researchers, emphasized the importance of these results for future pandemics. “The faster recovery time could help ease the strain on healthcare systems and reduce public restrictions,” he said. In addition to COVID-19, increased FasL levels have been observed in patients with severe influenza infections, which may expand the potential uses for FasL inhibitors in the future. Further clinical trials are needed to confirm these findings, but the current study offers promising results.
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