Local infectious disease specialists said they would evaluate the potential of asthma treatment ciclesonide (brand name: Alvesco) against the new coronavirus.

Recently, the Institute Pasteur Korea (IPK) suggested that ciclesonide and niclosamide, an ingredient of animal tapeworm drug, as two medicines with a possible potency against the deadly virus that has no cure or vaccine.

Professor Kim Woo-ju of the Infectious Disease Department at Korea University Guro Hospital

Researchers at the IPK said they narrowed down 48 drugs authorized by the U.S. Food and Drug Administration to 24, which have shown the potential to become a Covid-19 treatment. Then, they picked the two medicines that showed antiviral activities in animal models.

The infectious disease experts said they would evaluate ciclesonide, one of the two picked by IPK.

Professor Kim Woo-ju of the Infectious Disease Department of Korea University Guro Hospital said he applied for an investigator-initiated study to test ciclesonide’s clinical effectiveness in Covid-19 patients with mild symptoms. The Ministry of Food and Drug Safety gave the nod on March 27.

Infectious disease department professors at 11 university hospitals are participating in the study.

The clinical trial will enroll 141 mild Covid-19 patients and divide them into three groups -- ciclesonide alone group, ciclesonide plus hydroxychloroquine group, and conservative standard treatment group. The patients will be randomly assigned for observation.

Patients will orally inhale ciclesonide 320ug twice a day at 12-hour intervals for 14 days, and hydroxychloroquine 400mg, once daily for 10 days.

Primary endpoints include the negative rate of respiratory virus (on day 7, 14), the time until the virus turns negative (days), the period until clinical improvement (days), and the fraction of clinical failures.

Kim, the principal investigator of the study, said he has been closely monitoring news articles that said ciclesonide was effective in Covid-19 treatment. He said, “The IPK said ciclesonide’s viral suppression in a lab test showed a good outcome and proposed to me that I could do the trial. After discussion within the Korean Society of Infectious Diseases, I decided to lead the study.”

Kim assumed that ciclesonide, which is inhaled orally, would have antiviral and inflammatory control effects locally in the respiratory system. “I assume that it will improve clinical symptoms, shorten the hospitalization period, and prevent the worsening of severe cases by removing the virus quickly in mild patients, rather than in severe patients,” he added.

The study drew particular attention because the testing included Chloroquine (hydroxychloroquine), the emerging treatment for Covid-19.

The clinical trial passed the Institutional Review Board and began last week in earnest, Kim noted. “We will see whether ciclesonide’s effect in a lab test will be proven in a clinical study. As there is no cure for Covid-19, we are anticipating a good result.”

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