New / Potential Therapies in Dallas, TX

Experimental medications not available yet

  • NACE2i – restores ACE2 receptor function
  • BC007– works like an antibody

Useful Medications for Long Covid

  • Ivermectin
  • Pyridostigmine (Mestinon)
  • Low dose naltrexone (LDN)
  • Maravoc
  • Guanfacine or clonidine
  • Midodrine
  • Low dose abilify (aripiprazole)

Useful Supplements

  • Nattokinase
  • N-acetyl cysteine (NAC)
  • Curcumin
  • Bromelain
  • Quercetin

Other medication ideas (no trials yet)

  • Rapamycin: mTOR inhibitor

Anti-CD20 monoclonal antibodies

  • Rituximab (Rituxan) – anti cancer medication that targets the CD20 of B cells.  Used for autoimmune conditions.
  • ocrelizumab
  • ofatumumab
  • ublituximab

 

Anti inflammatories

  • pegcetacoplan – C3 (complement) blocker
  • danicopan – anti-factor D antibody
  • iptacopan -anti-factor B antibody
  • hydroxychloroquine (HCQ)
  • chantix (Varenicline)
  • methotrexate –  causes cells to release adenosine which blocks chemicals that promote inflammation.
  • colchicine – prevents microtubule assembly and thereby disrupts inflammasome activation, microtubule-based inflammatory cell chemotaxis, generation of leukotrienes and cytokines, and phagocytosis. Many of these cellular processes can be found in other diseases involving chronic inflammation. 

 

TNF inhibitors – many are subcutaneous and may only need 1-2 injections.

  • Adalimumab (Humira)
  • Adalimumab-adbm (Cyltezo) a biosimilar to Humira
  • Adalimumab-adaz (Hyrimoz), a biosimilar to Humira
  • Adalimumab-atto (Amgevita), a biosimilar to Humira
  • Hadlima (Humira biosimilar in outside USA)
  • Certolizumab pegol (Cimzia)
  • Etanercept (Enbrel)
  • Etanercept-szzs (Ereizi), a biosimilar to Enbrel
  • Golimumab (Simponi, Simponi Aria)
  • Infliximab (Remicade)
  • Infliximab-abda (Renflexis) a biosimilar to Remicade
  • Infliximab-dyyb (Inflectra), a biosimilar to Remicade
  • Tocilizumab (Actemra)

 

JAK inhibitors drugs currently available in the United States:

  • Xeljanz (tofacitinib)
  • Olumiant (baricitinib)
  • Jakafi (ruxolitinib)
  • Rinvoq (upadacitinib)
  • Inrebic (fedratinib)
  • Cibinqo (abrocitinib)
  • Opzelura (ruxolitini)

Interleukin inhibitors

·       Most of these are monoclonal antibodies against the specific interleukin receptor and/or the receptor.

·       Interleukins serve as messengers of inflammation.

IL-1 inhibitors – mainly used for rheumatoid arthritis

  • · anakinra (IL-1) – kineret
  • ·rilonacept (IL-1) – arcalyst
  • ·canakinumab (IL-1) – Ilaris

IL-4 & 13 – atopic dermatitis (eczema)

·       dupilumab – dupixant

IL-5 inhibitors – asthma, eosinophilic diseases, mast cells are also affected by IL-5, may be useful for MCAS.

  • ·       benralizumab – fasenra
  • ·       mepolizumab – nucala
  • ·       reslizumab – cinqair

IL-6 inhibitors – useful in autoimmune inflammatory conditions such a rheumatoid arthritis,

  • ·       tocilizumab (IL-6) – actemra
  • ·       olokizumab (IL-6) – Artlegia – bind IL-6 directly
  • ·       clazakizumab (IL-6) – Ocaliva
  • ·       sirukumab (IL-6)  – was rejected due to deaths
  • ·       sarilumab (IL-6) – Kevzara

Other interleukin inhibitors

IL-17: Psoriasis, psoriatic arthritis, ankylosing spondylosis, rheumatoid arthritis,

 IL-23:  treat plaque psoriasis, psoriatic arthritis, and Crohn’s disease.

  • ·       ustekinumab (IL-12/23) – Stelara
  • ·       brodalumab (IL-17) – Siliq
  • ·       secukinumab (IL-17) – cosentyx
  • ·       ixekizumab (IL-17) – Taltz
  • ·       guselkumab (IL-23) – tremfy

Other/Peptides

  • Honokiol – targeting mitochondrial dysfunction
  • rifaximin – gastric antibiotic meant for SIBO.
  • larazotide – peptide, zonulin antagonist, improves tight junctions barrier in gut
  • human ezrin peptide