Larazotide Promising Adjuvant Therapy for COVID-Related MIS-C

NEW YORK (Reuters Health) – Larazotide appears to be helpful in the treatment of COVID-19-related multisystem inflammatory syndrome in children (MIS-C), according to a new case series.

MIS-C is a rare but potentially life-threatening condition that typically develops in children weeks to months after they suffer a mild or even asymptomatic bout of COVID-19.

A recent study found that MIS-C is triggered by gastrointestinal breach of SARS-CoV-2 viral particles from the gut lumen into the bloodstream.

In an earlier study of MIS-C, researchers from Massachusetts General Hospital (MGH) and Brigham and Women’s Hospital in Boston showed that SARS-CoV-2 can linger in the gut for weeks to months after the infection, causing release of zonulin, a molecule that can lead to increased gut permeability and an impaired mucosal barrier. Larazotide decreases the release of zonulin.

The researchers gave larazotide to four extremely ill children being treated for MIS-C at MGH. They compared the clinical outcomes of the four children who received larazotide plus steroids and intravenous immune globulin (IVIG) with those of 22 children who received only steroids and IVIG.

Treatment with larazotide was well tolerated and led to significantly faster resolution of gastrointestinal symptoms and a slightly shorter hospital stay, Dr. Lael Yonker and colleagues report in Critical Care Explorations.

They note that serum levels of the highly inflammatory SARS-CoV-2 spike protein dropped much more quickly in children treated with larazotide, clearing from the blood within one day versus 10 days for children who did not receive larazotide.

These early findings suggest that larazotide “may provide a safe and beneficial adjuvant therapy for the treatment of MIS-C,” they conclude.

An ongoing randomized, double-blind, placebo-controlled phase-2a study (NCT05022303) of larazotide for the treatment of MIS-C is currently underway.

SOURCE: Critical Care Explorations, online February 23, 2022.

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