Hypothesis: Pentoxifylline is a potential cytokine modulator therapeutic
in COVID-19 patients
Abstract
We propose a new hypothesis that the established drug pentoxifylline
deserves attention as a potential repurposed therapeutic for COVID-19.
Pentoxifylline is an anti-inflammatory agent that suppresses adenosine
responses, reduces Tumour Necrosis Factor alpha, Interleukin 1, Interleukin
6 and Interferon gamma and may act to reduce tissue damage during the
cytokine storm response to SARS-CoV-2 infection. This agent has been
used clinically for many years and has a favourable profile of safety
and tolerability. Pre-clinical data support pentoxifylline as effective
in cytokine-driven lung damage. Clinical studies of pentoxifylline in
radiation and cytokine-induced lung damage in humans are positive and
consistent with anti-inflammatory efficacy. Pentoxifylline is a readily
available, off-patent, inexpensive drug suitable for large scale use,
including in resource-limited countries. Current trials of therapeutics
are largely focussed on the inhibition of viral processes. We advocate
urgent randomised trials of pentoxifylline for COVID-19 as a
complementary approach to target the host responses.