heparin + methylprednisolone

A combination therapeutic regimen consisting of heparin anticoagulants (either unfractionated heparin or low molecular weight heparin such as enoxaparin) and the synthetic corticosteroid methylprednisolone. This specific combination was evaluated in a Phase 3 randomized controlled trial (NCT04528888) sponsored by Massimo Girardis for the treatment of critically ill patients with COVID-19 pneumonia. The rationale for this dual therapy is to address the two primary drivers of mortality in severe SARS-CoV-2 infection: the hyperinflammatory host immune response (cytokine storm) and the pro-thrombotic derangements of the hemostatic system. Heparins function by activating antithrombin III, which subsequently inactivates thrombin and Factor Xa, thereby preventing microvascular and macrovascular thrombosis. Methylprednisolone acts as a potent anti-inflammatory agent by binding to the glucocorticoid receptor, modulating gene transcription to suppress the production of pro-inflammatory cytokines.

Other names

heparin-Massimo Girardis-COVID-19 pneumoniaSteroids and Heparin in Critically Ill COVID-19 PneumoniaSteroids and Unfractionated Heparin in Critically Ill Patients With Pneumonia From COVID-19 Infection