A combination of drugs proven to ease certain inflammatory diseases could help treat complications related to COVID-19 and possibly save lives, several Missoula doctors believe.
But getting approval to conduct a small pilot study on local COVID patients with underlying conditions hasn’t been easy. In fact, they said, their efforts have gone nowhere.
Dr. Walt Peschel, an 80-year old retired physician and researcher, said his combination of drugs have proven effective over several decades of testing to stop and sometimes reverse a number of chronic diseases, including blindness induced by diabetes and inflammation following heart surgery.
He believes the same combination of drugs may prevent at-risk patients who are infected with the novel coronavirus from dying as a result of certain complications.
“This will go to work tomorrow. These drugs are safe,” Peschel said. “They were deemed safe 40 years ago by the FDA. They could be delivered tomorrow for $3 a day with a prescription.”
Peschel said the drugs are individually available and approved by the FDA. But winning FDA approval to conduct a pilot study on the benefits of the drugs when prescribed in combination hasn’t been easy and stands beyond their resources.
Peschel met Tuesday with Missoula County commissioners and last week with Missoula Mayor John Engen, who has written the state’s congressional delegation asking for their help in getting approval for a small trial study.
“I’m writing today to ask that you work with Dr. Peschel’s team and urge the FDA to fast-track clinical trials in order to demonstrate whether his inexpensive ‘cocktail’ of already approved prescription medicines can indeed address the deadly symptoms of the virus,” Engen wrote. “I don’t know if Dr. Peschel’s therapy works, but I do think that based on his research to date, we owe it to ourselves to help him prove or disprove his theory.”
Peschel is a diabetic who suffered for years from complications of the disease, which can range from kidney and heart problems to eventual blindness. As his C-reactive proteins began to climb to unsafe levels, he began looking for a treatment.
C-reactive proteins are produced by the liver in response to inflammation in the body. Elevated levels of CRPs can be caused by various conditions ranging from infection to cancer, and high levels can be deadly.
“I worked frantically to find an anti-inflammatory that would lower the CRP and hopefully lower the progress rate of these diabetic-related diseases,” Peschel said. “I was very successful.”
Believing he was on to something, Peschel conducted an approved study with an eye doctor to see if the drug combination could prevent blindness induced by diabetes. At the time, he said, there was no way to stop progression of the disease.
Around that time, Peschel said, a separate and unrelated study with the National Institutes of Health applied two of the drugs in Peschel’s cocktail and successfully reduced the progression rate of diabetic blindness by 40%.
“We came back and repeated the same experiment using our four-drug combination,” Peschel said. “It had two of the first drugs they (NIH) used, plus two other drugs. We reduced the total progression of diabetic retinopathy by 100%. They totally went back to normal vision and held for a year.”
Unfortunately, Peschel said, he never published the study, but he did continue his research. It would eventually include fellow Dr. Goerge Reed, a Missoula cardiologist who underwent heart surgery a decade ago.
Reed said Peschel’s drug combination proved successful in treating his condition before and after surgery. He remains on the four-drug prescription and his inflammatory markers remain down.
“I’m a believer that this combination of therapy may have anti-inflammatory help in inflammation diseases, and certainly COVID is one of them,” Reed said. “I’ve followed (Peschel) and his efforts in this over time.”
Reed has since joined Peschel’s efforts to conduct a local trial study on 10 to 15 patients infected with COVI-19.
“These drugs are simple drugs but used in combination,” Reed said. “I would suggest recruiting people over a certain age who have diabetes and obesity and see how their inflammatory markers work.”
Peschel and Reed are urging the Missoula City-County Health Department to allow certain patients who test positive for COVID-19 to opt into a study on the drug combination. So far, the health department hasn’t agreed to do so.
While young COVID patients often power through the infection with few symptoms beyond a mild increase in c-reactive proteins, resulting in flu-like illness, Peschel said the outcomes can be far deadlier for older patients, and those with underlying conditions.
“If you’re old and have chronic disease, the same virus, the same dose of virus can turn the immune system on way more,” Peschel said. “It makes sense that if we could repeat Dr. Reed’s heart bypass study with the same medicine, only instead of heart bypass patients use it on people infected with the COVID virus, we could see if we can keep their CRPs down and prevent their hospitalization and mortality.”
Peschel said the past studies he’s conducted have been “very successful in holding CRPs down to unprecedented levels.” He needs permission to launch a trial study to see if the same outcome can be achieved in COVID patients.
“We may be able to save some of those people,” he said. “We can’t keep them from getting the virus. But if we can keep them from getting really sick and dying, the economy and our lifestyle and life expectancy will be able to go forward.”