Fowler: Pulmozyme to Improve COVID-19 ARDS Outcomes [Dornase alfa]

Estimated 60 patient dornase alfa late treatment RCT with results not reported over 4 years after estimated completion.

4 dornase alfa RCTs have results missing long after expected1-4
The trials report a total of 297 patients, with 2 trials having actual enrollment of 177, and the remainder estimated.

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1. Fowler et al., Pulmozyme to Improve COVID-19 ARDS Outcomes, NCT04402944, clinicaltrials.gov/study/NCT04402944clinicaltrials.gov.

2. Grégoire et al., Efficacy and Safety of Dornase Alfa Aerosol in ARDS Secondary to SARS-CoV-2 Coronavirus Respiratory Infection - COVID-19, NCT04355364, clinicaltrials.gov/study/NCT04355364clinicaltrials.gov.

3. Ovalı et al., Determination of Dornase Alpha Effectiveness in COVID-19 Treatment, NCT04432987, clinicaltrials.gov/study/NCT04432987clinicaltrials.gov.

4. Markova et al., A Prospective Open-label Study of the Tigerase® Efficacy and Safety as Part of Complex Therapy in Patients With COVID-19, NCT04459325, clinicaltrials.gov/study/NCT04459325clinicaltrials.gov.

Fowler et al., 31 Dec 2021, Double Blind Randomized Controlled Trial, placebo-controlled, USA, trial NCT04402944 (history). Contact: robert.fowler@childrens.harvard.edu, mailto:kzambranovera@bwh.harvard.edu, ssmith3@southshorehealth.org.

Late treatment
is less effective

Most accessed treatments

Antiviral effects

Vitamins & Minerals

Host endosomal entry / trafficking

Dual-action mAbs

RdRp

Nasal & Oral Sprays / Rinses

Analgesics

Antiandrogens

Host targets and pathways

Inflammatory and immune modulation

Mpro (Gen 1)

Oxidative stress and cytoprotection

Lifestyles

TMPRSS2

Spike neutralization

Replication inhibition (target unresolved)

COVID-19 mAbs

Pleiotropic modulation

Attachment / entry inhibition

Mpro (Gen 2)

H1RAs

Nutrients and microbiome support

Host mAbs

IL-6 / IL-6R blockade

Physical and extracorporeal interventions

Natural products and extracts

Symptom management

Unconfirmed antiviral rationale

Lifestyle, behaviors, and exposure prevention

Other complication management

Mpro / 3CLpro

Host pyrimidine synthesis

Direct viral inactivation

Endothelial / vascular protection

Direct respiratory tract treatments

Other antibodies, proteins, peptides, cells, and RNA therapies

Secondary infection and coinfection management

Pulmozyme to Improve COVID-19 ARDS Outcomes