When Amgen won FDA approval for Corlanor (ivabradine) to treat chronic heart failure in 2015, it didn’t generate much enthusiasm in the cardiology community and was quickly overtaken by Novartis’ Entresto, which was seen as having a better risk-benefit profile.
Now, researchers at the University of California, San Diego (UCSD) say they may have found a new market for Corlanor: to treat COVID-19 “long haulers.”
The team made the proposal after completing a small study of Corlanor in 22 patients with postural orthostatic tachycardia syndrome (POTS), a disorder that causes a spike in heart rate while standing along with other symptoms like fatigue, weakness and brain fog. Some COVID-19 patients complain of similar symptoms for months after they’ve recovered from the virus.
Patients in the trial who received Corlanor twice a day for one month saw their standing heart rate drop from between 100 and 115 beats per minute to 77 as compared to people taking a placebo, the UCSD team reported in the Journal of the American College of Cardiology. Patients taking the Amgen drug reported no significant side effects and an increased quality of life.
The study was led by Pam Taub, M.D., a cardiologist at the Cardiovascular Institute at UCSD Health and a consultant for Amgen. Although Corlanor is not approved to treat POTS, “we thought it could be helpful for patients with POTS as it reduces heart rate without impacting blood pressure," Taub said in a statement. Other drugs to treat the condition, such as beta blockers, can cause depressed blood pressure and fatigue.
Drug repurposing has been embraced as a potential strategy for addressing the COVID-19 pandemic, as public health officials struggle to meet demand for vaccines while simultaneously confronting new variants of the virus. Last month, researchers at the Icahn School of Medicine at Mount Sinai and UC San Francisco published a preclinical study suggesting that PharmaMar’s multiple myeloma drug plitidepsin outperformed Gilead Sciences' remdesivir in battling the original strain of SARS-CoV-2 as well as a variant that originated in the U.K.
PTC Therapeutics and Veru are both testing their early-stage cancer drugs in COVID-19. Last week, shares of Veru skyrocketed on phase 2 data showing its drug significantly reduced the days on ventilation for severely ill COVID-19 patients. Veru is planning a phase 3 trial.
Before POTS was spotted as a potential symptom in COVID-19 long-haulers, it was most commonly seen in young, active women who had recovered from other viral infections, trauma or surgery. There are no FDA-approved drugs to treat POTS.
The UCSD researchers hope physicians treating POTS patients will consider using Corlanor off-label, they said, and that future studies will be designed to further investigate the potential of Amgen’s drug in addressing symptoms of the disease.