A novel nasal spray treatment appears to show promise in quickly clearing the coronavirus that causes covid-19 from our nostrils. In a recent Phase III trial in India, the spray was found to significantly reduce people’s nasal viral load within days and at a faster rate than those who received a placebo. Treated people also tested negative for the virus on a swab test faster than the placebo group.
The potential treatment is being primarily developed by the Canadian company SaNOtize, with different partners in various countries, such as Glenmark Pharmaceuticals in India. It contains nitric oxide, a molecule with several important roles in the human body that is also used as medication to help widen the airways and blood vessels in people with certain conditions. Some research has indicated that nitric oxide can have a potent antimicrobial effect as well, and that’s led to hopes that it could be deployed as a frontline covid-19 treatment for people soon after a suspected or confirmed exposure to the coronavirus. If so, a nasal spray may be the best method of delivery, since infection often starts in the upper respiratory tract.
Details of the randomized, double-blinded, placebo-controlled trial were published last week in The Lancet Regional Health-Southeast Asia. It enrolled more than 300 adults confirmed to have covid-19 and mild symptoms (both vaccinated and unvaccinated). Two groups used a nasal spray six times a day for seven days, though only one group received the real treatment.
On average, those who took nitric oxide appeared to clear the virus from their nose earlier than the placebo group, with their overall viral load judged to have decreased by 99% within 48 hours. The median length of time for those in the treatment group to test negative for the virus was day three, compared to the seven-day median seen with the placebo group. The treatment was also well-tolerated, with only a few participants reporting mild adverse effects such as nasal discomfort. The trial took place during periods of the pandemic when the Delta and Omicron variants were widely circulating, suggesting that it was similarly effective against either.
“The Phase 3 study results strongly support the safety and efficacy of [the nitric oxide nasal spray] in the treatment of COVID-19 and its known variants,” said SaNOtize Co-Founder and CEO Gilly Regev in a statement jointly released by the company and Glenmark.
In February 2022, the nasal spray was cleared for use and launched in India under an accelerated approval process, under the name Fabispray. It’s also been cleared and is now being sold in parts of Asia and Israel under different names, and it has been registered as a medical device in the European Union. There don’t seem to be any recent updates on its potential development and availability in North America, though at least one trial is ongoing in Canada, as well as in Sri Lanka.
While the results in this latest trial do seem to be the largest yet of any nitric oxide treatment for covid-19, there are some lingering questions. Right now, for instance, the results suggest but don’t demonstrate for certain that nitric oxide can reduce the severity of symptoms, the risk of further transmission to others, or the odds of worsening illness—the latter being especially important for higher-risk individuals. A greater proportion of those on the spray did report feeling noticeably better by day eight then the placebo group (78% vs 62%), though.
Should more research continue to find similarly positive data, SaNOtize hopes that this spray won’t just be useful against covid-19 but other respiratory infections, particularly influenza.