New Covid treatment for patients with diabetes shows early promise

University College London

A new Covid-19 treatment for people with diabetes has shown promising results in a trial led by UCL researchers.

Prof John Martin

The trial was conducted by St George Street Capital (SGSc) – a medical research charity – with the the goal to find new purposes, where there is a real clinical need, for drugs that have already passed safety checks

Professors John Martin (UCL Division of Medicine) and Pete Coffey (UCL Institute of Ophthalmology) founded the charity along with an American philanthropist to trial new medicines four years ago. They focused on a number of medicines shown to be safe in phase I clinical trials which had been abandoned by the pharmaceutical industry, but may still be beneficial for other purposes.

Over the last year, SGSc have been trialling a drug (AZD1656) in diabetic patients. The drug was gifted to the charity by Astra Zeneca. The team recognised that it could activate cells from the immune system as a potential treatment for people with the SARS-CoV-2 virus by dampening the overactive response of the immune system which causes damage to the organs in the body, particularly the heart and lungs.

The trial reduced the number of deaths in patients receiving AZD1656, a promising finding which will need to be analysed further by the researchers, when cellular immunology results become available, before the study results undergo peer review. The reduced mortality for patients on AZD1656 was observed on top of benefits from other medications, such as dexamethasone, as part of standard of care. AZD1656 was shown to be well-tolerated with no serious adverse reactions occurring.

Diabetes, whether type 1 or 2, has been the leading single cause of co-morbidity during the pandemic and one in three of all deaths with Covid-19 in hospital in England have been associated with diabetes.

The objectives of the clinical trial, called ARCADIA, were to assess the efficacy, safety and tolerability of the drug, a glucokinase activator, and to determine the effect of the therapy on clinical improvement and mortality.

The recently completed ARCADIA phase ll trial, led by St George Street Capital, was randomised, double-blind, placebo-controlled and carried out in 158 patients. The trial was funded by international investment and the UKRI/Innovate UK programme.

The researchers say their data supports continued investigation of AZD1656 for the treatment of people with diabetes who have Covid-19 in future clinical trials. They also hope to trial the drug in people without diabetes potentially benefiting an even larger group of people such as patients with long Covid.

Professor Martin, Chairman of SGSC and Principal Investigator on the UKRI grant said: “We have demonstrated our ability to rapidly deliver a clinical trial in 16 months from conception to completion. The promising results from this trial indicate that AZD1656, a simple oral tablet, has the potential to become a new treatment for Covid-19. It is beneficial regardless of viral mutations. It is the first specific treatment for Covid disease (as opposed to antivirals or vaccines) and may herald a new field of drugs activating cells in the body which become themselves the therapeutic agent.”

Professor Coffey added: “Our study demonstrates the potential outcomes of partnerships with pharma in repurposing drugs for use in unmet clinical need is immense. St George Street Capital has proven this model.”

On Thursday this week, the team’s work was recognised at a reception at 10 Downing Street attended by Professor Martin. The reception was held to celebrate the UK-United Arab Emirates prosperity and innovation partnership, as the UAE’s sovereign wealth fund contributed to the trial’s funding.

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