UC researcher urges caution using drug to treat COVID-19

In the UC study, lead author Bingfang Yan, a pharmaceutical scientist, and his UC graduate students Yue Shen and William Eades, found that the drug permanently stops the activity of an enzyme called CES-2, which is found in the intestine, liver and kidney and is needed for the breakdown of many medications.  

“This enzyme normally breaks down and activates medicines in certain antivirals or inactivates other medicines such as in certain anticoagulants,” says Yan, professor at the James L. Winkle College of Pharmacy. On the other hand, he says this breakdown increases the toxicity of many more medications such as with heart medicines and anticancer drugs.  

An antiviral is a drug that fights viruses, and an anticoagulant is a drug that hinders the clotting of blood.

What further complicates the issue, Yan says, is that when delivered through an IV, remdesivir does not treat the virus unless the body has additional specific enzymes, which are not found in all patients. It can also cause other antiviral drugs, such as those used for HIV/AIDs and hepatitis C, to not work properly.    

Remdesivir is only administered through the veins in a hospital setting, and the FDA typically recommends a dose of once a day, for approximately 10 days. “intravenous injection of remdesivir can cause safety concerns because of high initial concentrations of the drug in the system,” says Yan, noting, “If physicians use it, they have to use it with caution.

"Clearly, the treatment should be used for the right patients and in the proper dosages with care when used in combination with other medications.”

Yan’s UC laboratory studies how drugs are metabolized in the body to see if certain people should or should not use the drug or use it at a different dose. He has, for decades, been supported by the National Institutes of Health.

Photo at top is the exterior of the James L. Winkle College of Pharmacy. Photo/Colleen Kelley/UC Creative + Brand