Camostat is a
serine protease inhibitor. Serine protease enzymes have a variety of functions in the body, and so camostat has a diverse range of uses. Camostat is approved in Japan for the treatment of chronic
pancreatitis and postoperative
reflux esophagitis.[1][2] The oral proteolytic enzyme inhibitor has been on the market since 1985 under the trade name Foipan Tablets. The manufacturer is
Ono Pharmaceutical. The drug is used in the treatment of some forms of
cancer and is also effective against some
viral infections, as well as inhibiting
fibrosis in liver or kidney disease or pancreatitis.[3][4][5][6][7]
As side effects allergic reactions including
anaphylaxis, hypersensitivity,
hyperkalemia, platelet and leukocyte depletion, liver dysfunction, jaundice have been reported.[9]
COVID-19
Camostat 100mg tablets (Japanese Blister)
Inhibition of TMPRSS2 partially blocked infection by
SARS-CoV and
Human coronavirus NL63 in
HeLa cell cultures.[10]
Another in vitro study showed that camostat significantly reduces the infection of
Calu-3 lung cells by
SARS-CoV-2, the virus responsible for
COVID-19.[11][12] It is currently in many Phase 1 and Phase 2 clinical trials.[13][14]
Camostat decreased
CRP levels better compared to
Lopinavir/
Ritonavir in a small study of mild COVID-19 patients.[15] Camostat decreased COVID-19 severity, improved inflammatory markers and oxygenation compared to
hydroxychloroquine treated patients.[16][12]
A study of 205 COVID-19 patients treated with Camostat, carried out at
Aarhus University Hospital in
Denmark and concluding in April 2021, showed no noticeable effects of Camostat on duration of hospitalisation or severity of the cases, but noted that higher doses (the study used 600 mg Camostat daily dosage) might still have a possible effect.[17]
On July 1, 2021, the AIDS Clinical Trials Group announced that the Camostat group on the "ACTIV-2 Outpatient Monoclonal Antibodies and Other Therapies Trial" would not be moving forward to Phase 3. The trial demonstrated no safety concerns but also no changes in viral shedding or symptom improvement.[18]
^Kitamura K, Tomita K (February 2012). "Proteolytic activation of the epithelial sodium channel and therapeutic application of a serine protease inhibitor for the treatment of salt-sensitive hypertension". Clinical and Experimental Nephrology. 16 (1): 44–48.
doi:
10.1007/s10157-011-0506-1.
PMID22038264.
S2CID6522071.
^Ueda M, Uchimura K, Narita Y, Miyasato Y, Mizumoto T, Morinaga J, et al. (2015). "The serine protease inhibitor camostat mesilate attenuates the progression of chronic kidney disease through its antioxidant effects". Nephron. 129 (3): 223–232.
doi:
10.1159/000375308.
PMID25766432.
S2CID207652863.
Kunze H, Bohn E (May 1983). "Effects of the serine protease inhibitors FOY and FOY 305 on phospholipase A1 (EC 3.1.1.32) activity in rat - liver lysosomes". Pharmacological Research Communications. 15 (5): 451–459.
doi:
10.1016/S0031-6989(83)80065-4.
PMID6412250.
Göke B, Stöckmann F, Müller R, Lankisch PG, Creutzfeldt W (1984). "Effect of a specific serine protease inhibitor on the rat pancreas: systemic administration of camostate and exocrine pancreatic secretion". Digestion. 30 (3): 171–178.
doi:
10.1159/000199102.
PMID6209186.