IIT Madras study shows efficacy of non-steroidal drug in Covid treatment

Widely used since 1960s as an anti-inflammatory formulation, Indomethacin also works as an antiviral agent in mild and moderate Covid-19 cases

A study conducted by a team of experts from IIT-Madras has shown ‘excellent efficacy’ of Indomethacin, a non-steroidal anti-inflammatory drug, as an antiviral agent in the treatment of mild and moderate COVID-19 patients.

Indomethacin, with more than two million prescriptions per year in the US alone, is an established drug widely used since the 1960s to treat various types of inflammation-related diseases. The Indian researchers are the first to show the efficacy of indomethacin through a randomised clinical trial though the scientific basis. The entire study was funded by Kris Gopalakrishnan an alumnus of IIT Madras and Chairman of Axilor Ventures.

The study conducted at Panimalar Medical College and Research Institute was led by Dr Rajan Ravichandran, an adjunct faculty at IIT Madras and Director Nephrology at MIOT hospitals. The study was conceptualised and coordinated by R Krishna Kumar, Institute professor, IIT Madras.

“Knowing that one of the deadly effects of the COVID infection is inflammation and the cytokine storm, we decided to study the non‐steroidal anti‐inflammatory drug, Indomethacin. The scientific evidence strongly shows the anti-viral action against Coronavirus. Indomethacin is a safe and well-understood drug. I have been using it in my profession for the past thirty years,” Ravichandran said.

According to the scientists, out of a total of 210 admitted patients 107 were randomly allocated to a control group, treated with paracetamol and standard care of treatment. 103 patients were administered indomethacin along with standard care of treatment.  The patients were monitored every day for symptoms such as cough, cold, fever and muscle pain along with oxygen saturation. Interestingly, none of the 103 patients who received indomethacin developed oxygen desaturation.

On the other hand, 20 of the 109 patients from the control group were desaturated with oxygen saturation levels below 93 per cent. Indomethacin group patients recovered from all symptoms in three to four days. It took double the time for the control group. Liver and kidney function tests showed no adverse reaction. “The fourteenth‐day follow‐up showed that nearly half of the control group patients had several discomforts while a few indomethacin patients complained only of tiredness”, Kumar said.

The work was chosen for peer review by Rapid Reviews; COVID-19, run by a team from Univ. California Berkeley and MIT Press.

The results in this work support and extend an earlier study by the team that was published in the Journal of the Indian Medical Association.   In the earlier study, 72 patients were administered Indomethacin and 72 other patients, Paracetamol.  This study also showed that only one patient under Indomethacin treatment developed hypoxia, compared to 28 in the Paracetamol group.  Furthermore, the administration of Indomethacin to patients having severe COVID symptoms, prevented the need for ventilation.

“Indomethacin works with all variants. We had done two trials, one in the first wave and the other in the second wave. The results were the same. I sincerely hope ICMR takes note of this study and includes indomethacin in COVID treatment protocol,” Ravichandran added.