CALGARY, Alberta, Canada—XORTX Therapeutics Inc. announced earlier today that the company is exploring the potential of using XRx-101 — a new formulation of oxypurinol — as a novel treatment for acute kidney and lung injury accompanying coronavirus infection, and specifically for the COVID-19 infection. Now the company has filed new intellectual property rights for XRx-101 for the treatment of respiratory and kidney disease due to viral infection.
XORTX reviewed recent studies characterizing the outbreak of COVID-19 in mainland China, noting that these reports “clearly illustrate that acute kidney injury and acute pulmonary injury are key factors in the most serious cases of COVID-19 hospitalization and death.” Studies of coronavirus infections show that SARS, MERS and particularly COVID-19 can be frequently accompanied by pneumonia, acute kidney injury, proteinuria and hematuria.
Acute kidney injury (AKI) has been identified as an independent risk factor for patients’ in-hospital mortality due to COVID-19, as well as other coronavirus infections. Early reports suggested a lower incidence (3% to 9%) of AKI in those with COVID-19 infection, but more recent reports have shown a higher frequency of renal abnormalities. A study of 59 patients with COVID-19 found that 34% of patients developed massive albuminuria on the first day of admission, and 63% developed proteinuria during their stay in the hospital.
Based on these recent studies, XORTX believes that XRx-101 has the potential to be a front-line treatment for severe cases of coronavirus, with the ability to decrease morbidity and mortality in hospitalized patients. Coronavirus infections have high mortality rates, with SARS, MERS and COVID-19 having rates of 10%, 37% and 4%, respectively. While COVID-19’s mortality rate is currently reported as lower than SARS and MERS, COVID-19 is much more contagious — as evidenced by its rapid worldwide spread.
XORTX’s belief that XRx-101 is a possible treatment for COVID-19 is based upon its potential anti-viral properties, and historic animal and human data that show that acute tissue injury can lead to rapid accumulation of uric acid and uric acid crystals, which leads to acute kidney injury.
“XORTX has begun a comprehensive review of the potential for XRx-101 to be a novel treatment for Coronavirus infection and its health consequences. Oxypurinol is a well studied drug that is known to be clinically safe and effective at decreasing production of uric acid, as well as a potential anti-viral agent,” said Dr. Allen Davidoff, chief executive officer of XORTX. “Owing to its advanced development status, Oxypurinol could be quickly developed to help treat those most severely affected by COVID-19.”
When acute kidney injury accompanies pneumonia, post-discharge outcomes are worse than with either diagnosis alone. Patients who survive a pneumonia hospitalization and develop acute kidney injury are at high risk for major adverse kidney events, and should receive careful follow-up. Oxypurinol has been previously studied for anti-viral properties, a characteristic that may decrease morbidity and mortality of COVID-19. It has also received an approval letter from the U.S. Food and Drug Administration in the past, potentially accelerating development for this purpose.
XORTX conceives of XRx-101 as having a potential triple action effect: decreasing the production of uric acid and increasing aqueous solubility of uric acid, thus decreasing uric acid crystal formation. Any agent that decreases the severity of primary or secondary pneumonia, leading to acute kidney injury, has the potential to be highly relevant. And xanthine oxidase inhibitors have been reported to have a potent antiviral effect against influenza-A virus, suggesting a third potential therapeutic method for coronavirus suppression.