Clofazimine: An Old Drug for Never-Ending Diseases

Riccardi, Niccolò; Giacomelli, Andrea; Canetti, Diana; Comelli, Agnese; Intini, Enrica; Gaiera, Giovanni; Diaw, Mama Moussa; Udwadia, Zarir F; Besozzi, Giorgio; Codecasa, Luigi; Biagio, Antonio Di

doi:10.2217/fmb-2019-0231

Cited by 27 publications

(22 citation statements)

References 56 publications

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“…The infection by FIP virus in cats presented similar features to the SARS infection such as pulmonary lesions in humans (Paltrinieri 2004 ). Clofazimine is an old hydrophobic riminophenazine, has a wide range of antimycobacterial activity ranging from leprosy to nontuberculous mycobacterial diseases (Riccardi et al 2020 ). Taking the advantages of low price and long half-life and high drug concentration in the lungs, clofazimine with minimum adverse effects might be potential for treating COVID-19 (Ke et al 2020 ).…”

Section: Drug Repositioningmentioning

confidence: 99%

COVID-19: Antiviral Agents, Antibody Development and Traditional Chinese Medicine

et al. 2020

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The World Health Organization (WHO) has declared coronavirus disease 2019 (COVID-19) is the first pandemic caused by coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Currently, there is no effective anti-SARS-CoV-2 drug approved worldwide for treatment of patients with COVID-19. Therapeutic options in response to the COVID-19 outbreak are urgently needed. To facilitate the better and faster development of therapeutic COVID-19 drugs, we present an overview of the global promising therapeutic drugs, including repurposing existing antiviral agents, network-based pharmacology research, antibody development and traditional Chinese medicine. Among all these drugs, we focus on the most promising drugs (such as favipiravir, tocilizumab, SARS-CoV-2 convalescent plasma, hydroxychloroquine, Lianhua Qingwen, interferon beta-1a, remdesivir, etc.) that have or will enter the final stage of human testing-phase III-IV clinical trials. Keywords Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Á Coronavirus disease 2019 (COVID-19) Á Updates Á Drug repositioning Á Network-based pharmacology Á Antibody Á Traditional Chinese medicine

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Section: Drug Repositioningmentioning

confidence: 99%

COVID-19: Antiviral Agents, Antibody Development and Traditional Chinese Medicine

et al. 2020

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“…In post-cardiovascular surgical M. chimaera infections, many clinicians also added companion drugs such as clofazimine or linezolid to the regimen. While linezolid reaches cerebrospinal fluid concentrations of more than 80%, clofazimine does not cross the blood-brain barrier but has shown synergistic effects with amikacin [ 7 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

Long-Term Clinical and Multimodal Imaging Findings in Patients with Disseminated Mycobacterium Chimaera Infection

Zweifel

Wiest

Toro

et al. 2021

JCM

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Background: To analyze long-term ophthalmic clinical and multimodal imaging findings of disseminated Mycobacterium (M.) chimaera infection after cardiothoracic surgery among the Swiss Cohort. Methods: Systemic and multimodal ophthalmic imaging and clinical findings including rate of recurrence were reviewed and correlated to a previously proposed classification system of choroidal lesions and classification of ocular disease. Main Outcomes Measures: long-term clinical and multimodal ocular imaging findings of M. chimaera. Results: Twelve patients suffering from systemic infection from M. chimaera were included. Mean age at the first ophthalmic examination was 59 years (range from 48 to 66 years). Mean duration of the follow-up was 22.63 ± 17.8 months. All patients presented with bilateral chorioretinal lesions at baseline; 5 patients had additional signs, including optic disc swelling (2), choroidal neovascularization (1), retinal neovascularization (1) and cilioretinal vascular occlusion (1). Four recurrence events after discontinuation or adjustment of the antibiotic treatment were observed. Progressive choroiditis was seen in 5 patients under treatment, 4 of them deceased. Conclusions: Expertise from ophthalmologists is not only relevant but also critical for the assessment of the adverse drug effect of antimycobacterial treatment along with monitoring therapeutic response and identifying recurrences.

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“…Being a CYP3A4 substrate, its level is strongly reduced in case of co-administration with strong CYP3A4 enzyme inducers (e.g., rifampicin). Lopinavir/ritonavir increase plasmatic levels of delamanid and, then, the risk of toxicity ( Riccardi et al., 2020c ). It was recommended caution when prescribed with clofazimine ( Yadav et al., 2016 ).…”

Section: Methodsmentioning

confidence: 99%

“…Clofazimine is a hydrophobic riminophenazine which presumably interferes with the mycobacterial respiratory chain and ion transporters ( Riccardi et al., 2020c ).…”

Section: Methodsmentioning

confidence: 99%

Tuberculosis and pharmacological interactions: A narrative review

Riccardi

Canetti

Rodari

et al. 2021

Current Research in Pharmacology and Drug Discovery

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Even if major improvements in therapeutic regimens and treatment outcomes have been progressively achieved, tuberculosis (TB) remains the leading cause of death from a single infectious microorganism. To improve TB treatment success as well as patients' quality of life, drug-drug-interactions (DDIs) need to be wisely managed. Comprehensive knowledge of anti-TB drugs, pharmacokinetics and pharmacodynamic (PK/PD) parameters, potential patients’ changes in absorption and distribution, possible side effects and interactions, is mandatory to built effective anti-TB regimens. Optimization of treatments and adherence to international guidelines can help bend the curve of TB-related mortality and, ultimately, decrease the likelihood of treatment failure and drop-out during anti-TB treatment. Aim of this paper is to describe the most relevant DDIs between anti-TB and other drugs used in daily clinical practice, providing an updated and “easy-to-use” guide to minimize adverse effects, drop-outs and, in the long run, increase treatment success.

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Clofazimine: An Old Drug for Never-Ending Diseases

Cited by 27 publications

References 56 publications

COVID-19: Antiviral Agents, Antibody Development and Traditional Chinese Medicine

COVID-19: Antiviral Agents, Antibody Development and Traditional Chinese Medicine

Long-Term Clinical and Multimodal Imaging Findings in Patients with Disseminated Mycobacterium Chimaera Infection

Tuberculosis and pharmacological interactions: A narrative review

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