The ARCADIA trial (Alleviation of cardioRespiratory complications in patients with COVID-19 And DIAbetes) using AZD1656

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SGS is looking to run a clinical trial using a new drug, AZD1656 to treat diabetic patients suffering with COVID-19\. The potential drug AZD1656 was originally being explored for renal transplant rejection but it is hypothesised that the same mechanism of reducing excessive inflammation by the immune system could equally apply to those with severe coronavirus infection. Clinical observations have shown people with coronavirus can go through two stages of the disease. The first stage is an appropriate response of the immune system to fight the viral infection. In many people this is successful, and patients start to feel better after a week. In some people however the immune system overreacts, and they enter a second stage of the disease called 'hyperinflammation', where the body's own immune system starts to damage vital organs such as the lungs. Our potential treatment for COVID-19 aims to use the body's own mechanism of controlling excess inflammation by activating T regulatory cells. These T regulatory cells migrate to sites of inflammation such as the lungs, effectively dampening down the excess inflammation to reduce organ damage. In addition, AZD1656 has been shown to reduce blood glucose in patients with diabetes in clinical trials. Patients with both type I and type II diabetes are believed to be at higher risk of having more severe COVID-19 symptoms due to a number of biological factors, with blood glucose control being an important one. St George Street is aiming to start the clinical trial in July 2020, a vastly accelerated timescale driven by the urgency of the current pandemic. AstraZeneca will supply the formulated drug product at no cost to SGS and SGS will lead the clinical trial, enrolling 150 patients in hospitals in the UK over a 3-month timeframe. The primary objective of the trial through treating patients with AZD1656 is to reduce the number of diabetic patients with COVID-19 who decline and progress to the ICU.