A controversial publication about amantadine. Prof. Thrust: indiscriminate faith in this drug can be dangerous

“We propose amantadine as a new, cheap, readily available and effective treatment for COVID-19”, write the authors of the amantadine study published in Communications biology. The publication attracted a lot of attention, and experts warn: this study in no way confirms the effectiveness of amantadine in the treatment of COVID-19. – This is an overinterpretation that can be dangerous – explains the virologist, prof. Krzysztof Pyrć.

1. Amantadine is a drug used, inter alia, in in Parkinson’s disease. It got loud in 2020, when a doctor from Przemyśl, Włodzimierz Bodnar, announced that it was effective in the treatment of COVID-19, and he himself administered it to his patients
2. Despite many studies conducted in Poland and around the world, it has not been possible to confirm its effectiveness in the treatment of COVID-19 so far
3. However, the interest in the drug is huge, and its sales are growing rapidly, according to PEX PharmaSequence data. Some patients use amantadine on their own
4. – I strongly support the research that is currently underway, but before obtaining the results, recommending this drug as a drug with proven effectiveness is unethical and untruthful – says Krzysztof Pyrć, a virologist
5. You can find more such stories on the TvoiLokony home page

Let us recall that amandatin is a popular antiviral drug, once used in the treatment of influenza A, and nowadays administered in the treatment of Parkinson’s disease and the so-called parkinsonian syndromes, incl. reducing the tremors characteristic of them. However, amantadine became known in the COVID-19 pandemic. It has been suggested for months that it may help in the treatment of SARS-CoV-2 infection (due to its antiviral effect).

Amantadine: famous use, sales are growing

The treatment of COVID-19 with amantadine was publicized by Włodzimierz Bodnar, a doctor from Przemyśl. Despite many studies – conducted in Poland and around the world – it has not been possible to confirm the effectiveness of this drug in the treatment of COVID-19 so far. Poles, however, still believe in amantadine. Jan Pospieszalski recently admitted to using it. A few days ago we also wrote that the sales of amantadine in Poland is growing rapidly.

1. Sales of amantadine are growing rapidly. Even a veterinarian can give you a prescription

It is not surprising then that the publication in Communications biology on the drug aroused such widespread interest. We also wrote about it in Medonet, mistakenly saying that the text appeared in the pages of “Nature” – a prestigious scientific journal. The text can be read here: Amantadine in combating COVID-19. There is a new study and a new discovery.

In fact, Communications biology is published by the same publisher – Nature Publishing Group – however, completely different criteria are used to qualify manuscripts for publication.

What’s in the controversial article?

The text “Amantadine has the potential to treat COVID-19 because it inhibits the known and new ion channels encoded by SARS-CoV-2” was published on December 1 in Communications biology. An international team of scientists (from Denmark, Greece, Germany) writes in it, inter alia: “The urgent need to treat COVID-19 has inspired strategies to reuse approved drugs. Amantadine has been suggested and cellular and clinical studies have shown beneficial effects of this drug. We show that amantadine hexamethylene amiloride (HMA), but not rimantadine (amantadine derivative – editorial note), block the activity of the SARS-CoV-2 coronavirus E protein ion channel. It is worth noting that amantadine also blocks the activity of the ORF10 ion channel (…) ».

1. The original text from Communications biology is available here.

After the publication was published in Communication biology and its discussions in popular media, some experts from the world of science and medicine reacted very critically – both towards the content of the publication itself and its interpretation in the mass media.

The rest of the text is below the video.

Doctors: The authors of the study also did not investigate the effectiveness of amantadine as a drug

Dr. Bartosz Fiałek, a physician and promoter of medical knowledge about COVID-19, wrote on his Facebook profile that the article only mentions a preclinical study, and history knows cases in which substances intended to treat COVID-19 were lost in the course of further research, because they proved to be become ineffective.

In the post by Dr. Fiałka reads: “Amantadine is not currently recommended in COVID-19 therapy. In the cellular (preclinical) study under review, amantadine showed a potential beneficial antiviral effect on SARS-CoV-2. This study is a contribution to the planning of clinical trials assessing the effectiveness of amantadine in the treatment of COVID-19 in humans (studies are ongoing in two centers in Poland – funding from the Medical Research Agency; available clinical trials from other countries have not shown its effectiveness at the moment). In the history of preclinical studies, we already had substances that showed great activity against SARS-CoV-2, but in humans they did not confirm this activity, and even were harmful (the best example are antimalarial drugs – chloroquine / hydroxychloroquine; and also, among others, ivermectin, lopinavir, ritonavir tudzież oleandrin) ».

In a similar vein – and also on Facebook – the matter was commented on by prof. Agnieszka Szuster-Ciesielska, virologist from Lublin. «In the study, studies at the molecular level showed that amantadine inhibits SARS-CoV-2 ion channels, which may potentially inhibit its replication. But this the authors of the study did not investigate with the virus. They also did not test the effectiveness of amantadine as a drug »- she wrote in the post.

Prof. Thirst: It is untrue to say that amantadine heals COVID-19

So we asked Professor Krzysztof Pyrć from the Małopolska Center of Biotechnology of the Jagiellonian University to comment on the confusion. Prof. Pyrć is the deputy chairman of the COVID-19 advisory team to the President of the Polish Academy of Sciences, a member of the Science Against Pandemic initiative and a member of the Medical Council to the Prime Minister.

– The work that appeared in the pages of “Communications biology” is not wrong. The title is misleading and the sentence saying that the research results can serve as a guideline for amantadine treatment – explains Prof. Throw. And he adds: amantadine has been studied many times and so far has not been shown to be effective in the treatment of COVID-19. So recommending it, saying that it is the drug recommended for the treatment of COVID-19, is not true.

“People in Poland trust uncritically amantadine”

As explained by prof. For understanding the whole matter, the context is very important: the interest in amantadine in Poland is high, people still believe that the drug treats COVID-19, they are looking for it, they ask doctors to issue a prescription.

– There are many people in Poland who uncritically trust in the effectiveness of amantadine and when their condition worsens, instead of going to the hospital, they treat it on their own, and as a result they go to the hospital too late. When it finally happens, it may be too late and doctors will not be able to do anything – explains Prof. Throw.

Prof. Pyrć negatively assessed our publication on new research on amantadine.

What exactly needs to be clarified and corrected?

– MedTvoiLokony website wrote that the article was published in the prestigious journal “Nature” – that’s not true – explains prof. Throw. – This article appeared in the new journal “Communications biology”, which is published by the Nature Publishing Group. I am not questioning the quality of Communication biology, but using the authority of Nature is not correct here.

Prof. Pyrć: the article tells what we’ve known for a year

As the Krakow virologist explains, the research that is described in “Communications biology” does not bring much new. – A year ago, in a much better journal of this publisher, a publication appeared saying that amantadine, like other drugs, can bind to ion channels, and the SARS-CoV-2 virus E protein is such an ion channel – explains Prof. Throw. – The authors of the publications from a few days ago showed once again what we already know: that amantadine binds and inhibits the activity of the ion channel. Amantadine has not been shown to inhibit infection in vitro (laboratory) or in vivo (live). Even more so, it has not been shown that amantadine heals – he explains.

A very interesting biochemical mechanism has been shown, which may be helpful in the design of drugs in the future, explains Prof. Throw.

He adds that pre-clinical and clinical studies on amantadine have already been conducted around the world and have not shown its effectiveness. – This publication shows that this is a potential direction for further research, but it is not a basis for recommendations. In order to recommend the use of a drug, it is first necessary to prove its effectiveness in clinical trials. I strongly support the research that is currently underway, but before obtaining the results, recommending this drug as a drug with proven effectiveness is unethical and untruthful – explains the scientist from Krakow.

Read also:

1. What about amantadine? It will not be a life-saving drug
2. Prof. Flisiak: it will not be possible to prove the effectiveness of amantadine
3. Amantadine against COVID-19? Research in progress. What is already known?

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