Therapeutic potential of ciclesonide inhalation for COVID-19 pneumonia: Report of three cases

Abstract

No specific and effective anti-viral treatment has been approved for COVID-19 so far. Systemic corticosteroid has been sometimes administered to severe infectious diseases combined with the specific treatment. However, as lack of the specific anti-SARS-CoV-2 drug, systemic steroid treatment has not been recommended for COVID-19. We report here three cases of the COVID-19 pneumonia successfully treated with ciclesonide inhalation. Rationale of the treatment is to mitigate the local inflammation with inhaled steroid that stays in the lung and to inhibit proliferation of the virus by antiviral activity. Larger and further studies are warranted to confirm the result of these cases.

Drug Repurposing for Candidate SARS-CoV-2 Main Protease Inhibitors by a Novel In Silico Method

“…The potential multitarget activity of ciclesonide may help to overcome drug resistance in COVID-19. Additional favorable results were reported from studies identifying that ciclesonide inhalant may improve the respiratory status in severe COVID-19-induced pneumonia [ 20 ] and in cases of mild- to mid-stage COVID-19 [ 21 ]. Ciclesonide is a safe drug commonly used for inhalation in premature babies and newborns, as well as the elderly.…”

“…Ciclesonide is a safe drug commonly used for inhalation in premature babies and newborns, as well as the elderly. It is effective in controlling chronic inflammation of the respiratory tract and the only steroid that showed anti-SARS-CoV-2 activity [ 21 ]. These studies gave rise to a recently initiated an open-labeled, randomized Phase 2 clinical trial to evaluate the antiviral effect of ciclesonide on the reduction of viral load in patients with mild COVID-19 [ 22 ].…”

The inhaled steroid ciclesonide blocks SARS-CoV-2 RNA replication by targeting viral replication-transcription complex in culture cells

“…The treatment regime involves inhalation of 400 μ g ciclesonide (two or three times per day) for 2 weeks. Three cases of COVID-19 pneumonia treated successfully with ciclesonide have been reported (15), as have several case reports (16)(17)(18). None of these studies reported significant side effects.…”

Asthma and COVID-19: What do we know now

“… 20 , 31 , 32 Inhaled corticosteroids alone or in combination with bronchodilators have been shown to suppress coronavirus replication and cytokine production. 8 , 33 , 34 Interestingly, in an in vivo study, Matsuyama et al found that ciclesonide, an inhaled corticosteroid selectively suppressed human coronavirus replication in human cultured cells. 33 Additionally, in vitro studies have shown that formoterol, glycopyrronium, and a combination of formoterol, glycopyrronium and budesonide, have inhibitory effects on seasonal coronavirus replication and cytokine production.…”