Drug Repurposing for Measles Disease Treatment
Once again, Frontline Physicians discover and test what appears to be an inexpensive, off-patent treatment for a virus that causes lung disease
An Off-patent, Off-label Measles Disease Treatment
Dr. Richard Bartlett and his close colleagues have been very actively involved in treating patients who have developed measles infection and disease during the current West Texas outbreak. They have discovered that an off-patent drug, Budesonide, when administered by inhaler, can provide remarkable clinical responses in patients suffering from Measles disease. This is another example of an “off-label” use of an existing drug to treat symptoms caused by an infectious viral agent.
There has been a measles outbreak in West Texas, with the first reported death in Lubbock. Many of the cases are among unvaccinated individuals.
The measles vaccine (MMR II) carries similar risks as the wild measles virus, including potential for encephalitis, thrombotic purpura, and other complications. Parents should review the vaccine package insert to understand the risks.
There are indications that some of the measles cases may be due to shedding of the live virus from the measles vaccine, as a recent study found one-third of vaccinated children were shedding the vaccine virus.
The CDC and FDA recommendations on the MMR II vaccine differ, with the CDC recommending it for children as young as 6 months old, while the FDA labeling indicates it is only approved for 12 months and older.
Dr. Bartlett recommends using budesonide nebulizer treatments as an effective, low-risk treatment for measles, as it has been shown to help stop the inflammatory response and symptoms. He urges parents to educate themselves on the options and not rely solely on official health recommendations.
Budesonide, available in both brand and generic versions, can be purchased at significantly reduced costs through various methods. For instance, the generic version can be obtained for as low as $35.69, which is 97% off the average retail price of $1,416.44. Similarly, Budesonide ER can be acquired for around $254.26, representing an 83% discount off its average retail price of $1,522.77. Additionally, international online pharmacies may offer even lower prices, such as $0.09 per dose for 600 doses of Budesonide Inhaler (Budesonide) 100 mcg.
What are Measles Disease Signs and Symptoms?
Measles is a childhood infection caused by a virus. Once quite common, measles can now almost always be prevented with a vaccine.
Also called rubeola, measles spreads easily and can be serious and even fatal for small children. While death rates have been falling worldwide as more children receive the measles vaccine, the disease still kills more than 200,000 people a year, mostly children.
As a result of high vaccination rates in general, measles hasn't been widespread in the United States in about two decades. Most recent measles cases in the U.S. originated outside the country and occurred in people who were unvaccinated or who didn't know whether or not they had been vaccinated.
Measles causes a red, blotchy rash that usually appears first on the face and behind the ears, then spreads downward to the chest and back and finally to the feet.
Measles signs and symptoms appear around 10 to 14 days after exposure to the virus. Signs and symptoms of measles typically include:
Fever
Dry cough
Runny nose
Sore throat
Inflamed eyes (conjunctivitis)
Tiny white spots with bluish-white centers on a red background found inside the mouth on the inner lining of the cheek — also called Koplik's spots
A skin rash made up of large, flat blotches that often flow into one another
The infection occurs in stages over 2 to 3 weeks.
Infection and incubation. For the first 10 to 14 days after infection, the measles virus spreads in the body. There are no signs or symptoms of measles during this time.
Nonspecific signs and symptoms. Measles typically begins with a mild to moderate fever, often with a persistent cough, a runny nose, inflamed eyes (conjunctivitis) and a sore throat. This relatively mild illness may last 2 to 3 days.
Acute illness and rash. The rash is made up of small red spots, some of which are slightly raised. Spots and bumps in tight clusters give the skin a splotchy red appearance. The face breaks out first.
Over the next few days, the rash spreads down the arms, chest and back, then over the thighs, lower legs and feet. At the same time, the fever rises sharply, often as high as 104 to 105.8 F (40 to 41 C).
Recovery. The measles rash may last about seven days. The rash gradually fades first from the face and last from the thighs and feet. As other symptoms of the illness go away, the cough and darkening or peeling of the skin where the rash was may stay for about 10 days.
When can a person spread the measles virus? A person with measles can spread the virus to others for about eight days, starting four days before the rash appears and ending when the rash has been present for four days.
What is Budesonide?
Budesonide, sold under the brand names Pulmicort, Budecort, Rhinocort, Entocort (among others,) is a steroid medication. It is available in inhalers, nebulization solutions, pills, nasal sprays, and rectal forms. The inhaled form is used in the long-term management of asthma and chronic obstructive pulmonary disease (COPD).
Budesonide was initially patented in 1973. Commercial use as an asthma medication began in 1981. It is on the World Health Organization's List of Essential Medicines. Some forms are available as a generic medication. In 2022, it was the 177th most commonly prescribed medication in the United States, with more than 2 million prescriptions filled during that year.
What Medications Does Dr. Bartlett Recommend for Measles?
Recap
10-point summary of Dr. Bartlett’s key points from his recent interview on the measles outbreak:
1. Recent measles outbreak in West Texas, with the first reported death in years occurring in Lubbock.
2. The MMR2 vaccine can cause similar complications to wild measles, including rash, fever, encephalitis, and idiopathic thrombotic purpura.
3. A recent study showed that one-third of children who received the MMR2 vaccine shed the live measles virus, potentially contributing to outbreaks.
4. There’s a discrepancy between FDA and CDC recommendations on the appropriate age for MMR vaccination (12 months vs. 6 months).
5. The vaccine carries risks, especially for immunocompromised individuals and those with certain medical conditions or family histories.
6. Parents should read the MMR package insert and be fully informed about both risks and benefits before deciding to vaccinate.
7. Some measles cases in the current outbreak may be a result of the vaccine virus itself, as the same test is used for both wild and vaccine-induced measles.
8. Historical data suggests that measles outbreaks in the U.S. often originate from immigrants, raising concerns about border control and health screening.
9. Budesonide nebulizer treatments are showing promising results in treating measles symptoms, potentially reducing complications like encephalitis.
10. The treatment protocol developed by Dr. Bartlett and colleagues includes budesonide nebulizer treatments and antibiotics like clarithromycin to prevent secondary bacterial pneumonia, offering a low-risk alternative to solely relying on vaccination. Additionally over-the-counter nasal budesonide can also benefit in protection and treatment.
Dr. Bartlett also recommends parents in areas with an active measles outbreak keep the following over-the-counter items on hand in case they are needed, as well as various prescriptions he is using for specific symptoms of patients he is currently treating for measles.
Links for OTC items listed are below.
If you do not have these items and are in a region experiencing an active measles outbreak, we recommend getting them ASAP so you are prepared in case you or your child gets sick.
***Medical disclaimer: This newsletter was created for informational purposes only and has no ties to any drug company. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. ***
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