Tamsulosin [Flomax] "is a medication used to treat symptomatic benign prostatic hyperplasia (BPH) and chronic prostatitis and to help with the passage of kidney stones." [1]
"Tamsulosin is a selective α1 receptor [2] antagonist that has preferential selectivity for the α1A receptor in the prostate versus the α1B receptor in the blood vessels."
Joshua T. Vogelstein [Johns Hopkins] "and his colleagues have been trying to identify patterns among people who have survived cytokine storms and people who haven’t. One correlation the team noticed was that people taking the drug tamsulosin (sold as Flomax, to treat urinary retention) seemed to fare well. Vogelstein is unsure why. Cytokine storms do trigger the release of hormones such as dopamine and adrenaline, which tamsulosin can partially block. The team is launching a clinical trial to see if the approach is of any help." [3]
"A retrospective clinical study supporting the rationale for trials of Alpha-1 Adrenoreceptor Antagonists to prevent cytokine storm and severe COVID-19" [4]:
⍺1-AR antagonists "doxazosin, prazosin, silodosin, terazosin, or tamsulosin"
"The first cohort consisted of patients admitted with pneumonia, identified by the Agency for Healthcare Research and Quality’s (AHRQ) pneumonia category, which includes multiple codes from the ICD-9, respectively (Figure 1B). Of the 108,956 subjects in this cohort, 5,498 patients (5.0%) were taking ⍺ 1- AR antagonists. Overall, 8.9% of all patients received invasive mechanical ventilation and 2.1% both were ventilated and died in the hospital. We found that patients with prior use of ⍺ 1- AR antagonists had 12.9% lower incidence of invasive mechanical ventilation compared to non-users (OR = 0.86, 95% CI 0.78-0.95, p = 0.002; AOR = 0.83, 95% CI 0.75-0.92, p < 0.001). Further, those patients had a 16.0% lower incidence of both being ventilated and dying in the hospital (OR = 0.84, 95% CI 0.68-1.02, p = 0.044; AOR = 0.77, 95% CI 0.62-0.94, p = 0.007). By contrast, prior use of beta-adrenergic receptor (β-AR) antagonists was not correlated with either outcome in this cohort, with or without adjustment.
"The second cohort consisted of patients identified with International Classification of Diseases (ICD)-9 code 518.82 (which encompasses acute respiratory failure including ARDS) (Figure 1C). Of the 13,125 patients in this cohort, 655 (5.0%) had prior use of ⍺ 1- AR antagonists. Overall, 15.9% of all patients received invasive mechanical ventilation and 3.7% both were ventilated and died in the hospital. We found that patients with prior use of ⍺ 1- AR antagonists had 22.2% lower incidence of invasive mechanical ventilation compared to non-users (OR = 0.75, 95% CI 0.59-0.94, p = 0.008; AOR = 0.75, 95% CI 0.59-0.95, p = 0.009). Perhaps more importantly, those patients had a 36.0% lower incidence of both being ventilated and dying in the hospital (OR = 0.63, 95% CI 0.37-1.01, p = 0.037; AOR = 0.59, 95% CI 0.34-0.95, p = 0.021). By contrast, prior use of β-AR antagonists was not correlated with either outcome in this cohort."
-Patrick
[1] en.wikipedia.org/wiki/Tamsu...
[2] en.wikipedia.org/wiki/Alpha...
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