Title:Safety and Efficacy of Imatinib, Nilotinib, and Artesunate in COVID-19
Patients: A Systematic Review of Current Evidence
Volume: 22
Issue: 1
Author(s): Ehsan Ghavimehr, Ali Zand, Seyed Ahmad SeyedAlinaghi, Amirali Karimi, Hamid Zaferani Arani, Pegah Mirzapour, Zahra Pashaei, Esmaeil Mehraeen*Omid Dadras
Affiliation:
- Iranian Research Center for
HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
- Department of Health Information Management,
Arabdil University of Medical Sciences, Khalkhal, Iran
Keywords:
COVID-19, SARS-CoV-2, treatment, imatinib, nilotinib, tyrosine kinase inhibitor, chronic myeloid leukemia, artesunate, malaria, off-label.
Abstract:
Introduction: There is a need for better treatment options against COVID-19. This
systematic review aimed to assess the safety and efficacy of imatinib and nilotinib, two tyrosine
kinase inhibitors (TKIs), as well as artesunate (an anti-malarial agent), whose multilayer activities
against SARS, MERS, and SARS-CoV-2 pathogenesis have been suggested in laboratory
and observational studies.
Methods: A comprehensive search strategy targeting relevant literature on PubMed, Scopus,
and Web of Science online databases was constructed. The retrieved records were reviewed and
screened by title/abstract and full text with eligibility criteria, and the most pertinent articles
were included in the final qualitative synthesis. This review adhered to Preferred Reporting
Items for Systematic Reviews and Meta-Analyses (PRISMA) to ensure the reliability of the
results.
Results: This systematic review assessed the safety and applicability of imatinib, nilotinib, and
artesunate in COVID-19 patients. The results showed not only possible anti-COVID-19 effects
but also acceptable safety for both generic users with comorbidities with COVID-19 and offlabel
use in other COVID-19 patients. Promising results were also reported enhancing the survival
of COVID-19 patients.
Conclusion: A double-blinded multicenter randomized controlled trial found survival benefits
for imatinib with no significant treatment-related adverse events. However, no clinical trials or
large observational studies exist for artesunate and nilotinib, and the evidence relies only on
case reports and case series. Molecular mechanisms revealed in preclinical studies support the
possible benefits of these medications in COVID-19 treatment. However, the scarcity of reliable
evidence requires further studies on possible COVID-19 treatments, including but not limited
to artesunate, nilotinib, and imatinib. Nevertheless, these drugs' lack of serious adverse events
suggests their safe use for other indications during the COVID-19 pandemic.
