BTK Inhibitor Acalabrutinib Supports Patients with Severe Cases of COVID-19

Calquence (Acalabrutinib), Astrazeneca’s bruton tyrosine kinase inhibitor, is thought to treat COVID-19 by suppressing lung macrophages.

A medical professional inspecting blood samples.

Biopharmaceutical company AstraZeneca (LSE/STO/NYSE: AZN) has announced the publication of a study evaluating the utility of pharmacologic inhibitor of bruton tyrosine kinase (BTK) Calquence (Acalabrutinib) for the treatment of severe cases of COVID-19.

The article, “Inhibition of Bruton tyrosine kinase in patients with severe COVID-19,” was published in the journal Science Immunology and showed that the off-label administration of the drug to 19 hospitalized COVID-19 patients led to improvements in blood oxygenation and reduced levels of systemic markers of inflammation in the majority of the patients.

Executive Vice President of Oncology Research and Development at AstraZeneca José Baselga, MD, PhD, stated, “The science supporting investigation of the use of Calquence in patients with severe COVID-19 is strong. The encouraging preliminary data in this case series has informed the initiation of global phase II trials, notably the CALAVI programme.”

“We look forward to completing recruitment and obtaining data in these trials as soon as possible to further our understanding of what this potential treatment could mean for patients,” Dr. Baselga continued.

Acalabrutinib is thought to support COVID-19 patients by disrupting the BTK-dependent activation of macrophages in the lungs to mitigate immune hyperactivity and the systemic inflammation (“cytokine storm”) characteristic of severe cases of the disease.

The medication is approved in the United States for the treatment of certain blood-cased cancers including chronic lymphocytic leukaemia (CLL) but has not yet been approved for the treatment of infection by the SARS-CoV-2 virus that causes COVID-19.

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BTK regulates the production of pro-inflammatory signaling molecules including TNFa, IL-6, and MCP-1 by lung macrophages. According to the publication, blood monocytes isolated from patients with severe cases of COVID-19 had significantly higher levels of BTK activity and IL-6 production than those extracted from healthy volunteers.

After 10 to 14 days of treatment with Acalabrutinib, 4 out of 8 patients receiving mechanical ventilation were extubated and 8 out of 11 patients treated with supplemental oxygen were “discharged on room air.”

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