Trial of Long Covid treatment - AXA1125 from Axcella Therapeutics, 2021

Oxford to test potential treatment for fatigue in long COVID patients
https://www.ox.ac.uk/news/2021-10-29-oxford-test-potential-treatment-fatigue-long-covid-patients

Dr Alison Schecter, President of R&D at Axcella, said: 'While Long COVID’s enormous patient and socioeconomic burden has become apparent, its underlying pathophysiology is now emerging,” said . “In two prior successful clinical studies and in preclinical models, AXA1125 has demonstrated an ability to reverse mitochondrial dysfunction and improve energetic efficiency via increased fatty acid oxidation, restored cellular homeostasis, and reduced inflammation. This provides us with confidence about its potential to help the growing number of patients who are suffering from COVID’s debilitating effects long after contracting the virus.”

The Phase 2a trial will be a randomized, double-blind, placebo-controlled investigation to evaluate the efficacy and safety of AXA1125 in patients with exertional fatigue related to Long COVID. Approximately 40 patients will be enrolled and randomized evenly to receive either AXA1125 or a matched placebo.​

Unimpressed by the insistence to reduce everything to fatigue but whatever...

 

It does seem that fatigue is the medical equivalent of chicken.

 

I'm quietly hopeful of this working, it seems to fit with my feelings about what is wrong with me.

 

Is anything known about its mechanism of action? Is this a small molecule with a known target?

 

From the Axcella website: "AXA1125 is an EMM composition of six amino acids and derivatives."

If it is simply amino acids then is this essentially a nutritional supplement?

67.8 grams sounds like a lot!

 

Certainly if it's in solid form...

Even one gram (equal to a normal adult dose of 2 x paracetamol/acetaminophen tablets) is a lot to swallow!!

 

When I've taken amino acids such as BCAA it's in powder form mixed into a shake, drink, as with capsules I'd be taking than all day.

10 to 15g of powder in 200ml of liquid is not unusual, more if it's a whey based shake mix with something else added, where the whey component is 30g per 200ml of liquid, and then another 15g on top in the same 200ml of liquid.

One drink, 45g of powder, vs 45 capsules, for the same dose amount.

 

They probably think we should have no difficulty. After all, we've had to swallow an awful lot over the years.

 

Dr CS from MEA states (above) that the mitochondrial function for AXA1125 will be tested with MRS and he was tested nearly 40 years ago in the same way. Article in Lancet 1984. (Abstract Below)

https://www.sciencedirect.com/science/article/abs/pii/S0140673684918713

 

More on this in the Guardian: UK launches trial of drug to tackle fatigue in long Covid patients

 

I take them because they reduce PEM and help me digest carbs, but I've no idea why.

I once spent six or seven weeks getting though a tub of identical-looking but different supplements, which I'd picked up thinking they were BCAAs. I cursed the brand for selling fakes because they didn't work at all, but I couldn't afford a replacement tub. I only actually noticed when I washed out the jar for recycling that they were creatine or something.

 

Could it work like copaxone by offering up a decoy to antibodies

 

I had custom formulas made up based on my amino acid profile panels etc and they made no difference.

 

The Guardian article states:

"Further investigation revealed that they were accumulating lactic acid in their muscles at a faster rate than healthy individuals – a possible sign of mitochondrial dysfunction."​

Does anyone know which long covid study they might be referring to?

 

From:
Safety, Tolerability, and Biologic Activity of AXA1125 and AXA1957 in Subjects With Nonalcoholic Fatty Liver Disease
https://journals.lww.com/ajg/Fulltext/9900/Safety,_Tolerability,_and_Biologic_Activity_of.62.aspx

 

Those are also seemingly fairly standard components at pretty low dosages.

I can't believe that none of us have used them.

I probably have, with the exception of glutamine, as far as I remember.

Not a wonder drug.