Summary
We propose a new hypothesis that the established drug pentoxifylline
deserves attention as a potential repurposed therapeutic for COVID-19.
Pentoxifylline is an anti-inflammatory agent that suppresses adenosine
responses, reduces tumour necrosis factor α, interleukin 1, interleukin
6 and interferon γ and may act to reduce tissue damage during the
cytokine storm response to SARS-CoV-2 infection. This agent has been
used clinically for many years and has a favourable profile of safety
and tolerability. Pre-clinical data support pentoxifylline as effective
in cytokine-driven lung damage. Clinical studies of pentoxifylline in
radiation and cytokine-induced lung damage in humans are positive and
consistent with anti-inflammatory efficacy.
Pentoxifylline is a readily available, off-patent, inexpensive drug
suitable for large scale use, including in resource-limited countries.
Current trials of therapeutics are largely focussed on the inhibition of
viral processes. We advocate urgent randomised trials of pentoxifylline
for COVID-19 as a complementary approach to target the host responses.