Tricor (Lipanthyl): A Widely Available Drug has Remarkable Anti-COVID-19 Effects

Tricor (generic name: fenofibrate) was patented in 1969, and has been prescribed for more than fifty years as a generic fat-lowering treatment for patients with raised levels of cholesterol. It is used especially to target “bad” (LDL) cholesterol and fats such as triglycerides, and to raise “good” (HDL) cholesterol in the blood. It works by increasing the natural enzymes that break down fats in the blood. Now, some phenomenal news has recently been published about fenofibrate, coming from several studies of patients hospitalized due to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection.  In two separate studies in Israeli hospitals, groups of seriously ill patients infected with the novel coronavirus were observed, in the first case in order to find out whether any generally prescribed medications were having some effect on the progress of their infection, and in the second study to confirm the results of the first study, which was giving strong evidence of the remarkable effect of Tricor on COVID-19 patients.

What was the basis of this discovery?

As part of the worldwide scientific effort to find ways to defeat, or at least to reduce the effects of COVID-19 infections, Prof. Yaakov Nahmias of the Hebrew University of Jerusalem spent six months analyzing the impact of the numerous different medicines taken by 1,500 coronavirus patients that had been admitted to two Israeli hospitals. The importance of this study was that the subjects were already seriously ill, so any observed deviations from expected morbidity could be an important pointer to some direct change being due to the regular medication. In fact, this was what was seen. Of the total of 1500 admitted patients, thirteen were already on a regular regimen of fenofibrate to reduce their lipid levels, and had been doing so before the coronavirus infected them. The observed effect was that these thirteen patients recovered far faster than expected from virus-induced pneumonia. Had these 13 patients responded to COVID-19 with the same level of severity as the others in the study, expectations would have been for at least two deaths, but in fact there were none. What’s more, the likelihood was for at least six ICU admissions for the fenofibrate patients, but there was only one ICU admission. For the 1500 patients in the study, it was taking on average about 14 days to resolve their pneumonia, and although all the patients taking fenofibrate had developed pneumonia, it took them less than half that time to recover – just three to five days. 

A follow-up study has just confirmed the therapeutic value of Tricor.

To investigate whether fenofibrate could affect the progress of COVID-19 patients when administered as a therapy, Prof. Nahmias has conducted a study at the Barzilai Teaching Hospital in Ashkelon. In this program, 15 patients already seriously infected with novel coronavirus and on oxygen breathing support were given doses of fenofibrate. At the end of the 10-day trial every patient was discharged, healthy enough to go home.  Although there hasn’t yet been time for a double-blind placebo-controlled test, the statistics from these two studies are impressive. Usually, less than 30% of patients as badly infected as those in this study are expected to come off oxygen in under seven days. In this instance, 93% – 14 out of the 15 patients in the trial – came off oxygen in a significantly shorter time frame. As well, all regular studies of COVID-19 infections show that 80% to 90% of such patients would experience a cytokine storm, which is an immune overreaction that often causes a sudden deterioration. None of the 15 patients in this group experienced an observable cytokine storm.

What is the likely basis for the beneficial effect of fenofibrate?

Prof. Nahmias had an earlier hypothesis that lipids play a role in the severity of the disease due to the accumulation of lipids in the lungs of COVID-19 infected patients. His team hypothesized at the beginning of the study that the novel coronavirus is so vicious because it causes lipids to be deposited in the lungs. The observed results of the new study point to the possibility that fenofibrate could be acting to break down the lipids and so to help severely infected patients.

FAQ

What is Tricor/fenofibrate prescribed for?

Fenofibrate is in a class of medications called antilipemic agents that work by speeding processes that remove cholesterol from the body. It is sold in the US under several brand names, and is available from IsraelPharm as Lipanthyl®. It is the 73rd most prescribed drug in America. Tricor is typically prescribed along with a low-fat diet and exercise to reduce the amounts of fatty substances such as cholesterol and triglycerides in the blood and increase the amount of HDL (high-density lipoprotein) to lower the risk of heart disease. Atherosclerosis – the accumulation of cholesterol and fats on the walls of the arteries – decreases the volume of blood flow and so reduces the oxygen supply to the heart, brain, and other parts of the body. It increases the risk of heart disease, strokes, and heart attacks.

Will Tricor replace vaccination?

There is no question that vaccination remains the first line of defense against COVID-19. It helps prevent infection at the very beginning of the cycle.  While Tricor has tremendous potential to help people who are infected, it should not be used in place of a proper vaccination routine. Its merits lie in its ability to reduce morbidity, lower the degree of infection, prevent serious illness and speed up recovery for people who have been infected with the novel coronavirus.

Is fenofibrate a safe drug?

Fenofibrate is a widely used drug, and is safe to use in most cases. It may cause mild side effects, which should clear up after a few days.  Tell your doctor if any of these symptoms are severe or do not go away:

• constipation
• diarrhea
• heartburn
• pain in the back, joints or limbs
• headaches

Sometimes, people report more severe side effects.  It is important if you observe any of the following to stop the medication and consult with your healthcare professional or pharmacist:

• muscle pain, weakness, or tenderness
• fever
• blistering or peeling skin
• rash
• trouble in breathing
• changes in urination
• abdominal pain
• hives
• pain in the upper back between the shoulder blades or under the right shoulder
• stomach pain, especially in the upper right part of the stomach, along with  nausea and vomiting
• redness, swelling, pain, tenderness, or warmth in one leg
• shortness of breath, pain when breathing or coughing up blood
• swelling of the face, throat, tongue, lips, and eyes
• difficulty swallowing or breathing
• hoarseness