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Safety and efficacy of 5-aminolevulinic acid phosphate/iron in mild-to-moderate coronavirus disease 2019: A randomized exploratory phase II trial.


ABSTRACT:

Background

5-aminolevulinic acid (5-ALA), a natural amino acid that is marketed alongside sodium ferrous citrate (SFC) as a functional food, blocks severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) proliferation in vitro and exerts anti-inflammatory effects. In this phase II open-label, prospective, parallel-group, randomized trial, we aimed to evaluate the safety and efficacy of 5-ALA in patients with mild-to-moderate coronavirus disease 2019.

Methods

This trial was conducted in patients receiving 5-ALA/SFC (250/145 mg) orally thrice daily for 7 days, followed by 5-ALA/SFC (150/87 mg) orally thrice daily for 7 days. The primary endpoints were changes in SARS-CoV-2 viral load, clinical symptom scores, and 5-ALA/SFC safety (adverse events [AE] and changes in laboratory values and vital signs).

Results

A total of 50 patients were enrolled from 8 institutions in Japan. The change in SARS-CoV-2 viral load from baseline was not significantly different between the 5-ALA/SFC (n = 24) and control (n = 26) groups. The duration to improvement was shorter in the 5-ALA/SFC group than in the control group, although the difference was not significant. The 5-ALA/SFC group exhibited faster improvement rates in "taste abnormality," "cough," "lethargy," and "no appetite" than the control group. Eight AEs were observed in the 5-ALA/SFC group, with 22.7% of patients experiencing gastrointestinal symptoms (decreased appetite, constipation, and vomiting). AEs occurred with 750/435 mg/day in 25.0% of patients in the first phase and with 450/261 mg/day of 5-ALA/SFC in 6.3% of patients in the second phase.

Conclusion

5-ALA/SFC improved some symptoms but did not influence the SARS-CoV-2 viral load or clinical symptom scores over 14 days. The safety of 5-ALA/SFC in this study was acceptable. Further evaluation using a larger sample size or modified method is warranted.

SUBMITTER: Tanaka T 

PROVIDER: S-EPMC10470697 | biostudies-literature | 2023 Aug

REPOSITORIES: biostudies-literature

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Publications

Safety and efficacy of 5-aminolevulinic acid phosphate/iron in mild-to-moderate coronavirus disease 2019: A randomized exploratory phase II trial.

Tanaka Takeshi T   Tashiro Masato M   Ota Kenji K   Fujita Ayumi A   Sawai Toyomitsu T   Kadota Junichi J   Fukuda Yuichi Y   Sumiyoshi Makoto M   Ide Shotaro S   Tachikawa Natsuo N   Fujii Hiroshi H   Hibino Makoto M   Shiomi Hisanori H   Izumida Mai M   Matsui Kohsuke K   Yamauchi Momoko M   Takahashi Kensuke K   Yamanashi Hirotomo H   Sugimoto Takashi T   Akabame Shogo S   Umeda Masataka M   Shimizu Masumi M   Hosogaya Naoki N   Kosai Kosuke K   Takeda Kazuaki K   Iwanaga Naoki N   Ashizawa Nobuyuki N   Hirayama Tatsuro T   Takazono Takahiro T   Yamamoto Kazuko K   Imamura Yoshifumi Y   Miyazaki Taiga T   Kobayashi Yusuke Y   Ariyoshi Koya K   Mukae Hiroshi H   Yanagihara Katsunori K   Kita Kiyoshi K   Izumikawa Koichi K  

Medicine 20230801 34


<h4>Background</h4>5-aminolevulinic acid (5-ALA), a natural amino acid that is marketed alongside sodium ferrous citrate (SFC) as a functional food, blocks severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) proliferation in vitro and exerts anti-inflammatory effects. In this phase II open-label, prospective, parallel-group, randomized trial, we aimed to evaluate the safety and efficacy of 5-ALA in patients with mild-to-moderate coronavirus disease 2019.<h4>Methods</h4>This trial was co  ...[more]

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