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In a recent paper on why hydroxychloroquine doesn't really work against Covid-19, it's been demonstrated that SARS-CoV-2 is much better at taking advantage of TMPRSS2 at the cell membrane surface, so that the cathepsin-mediated endosomal-entry pathway (which hydroxychloroquine inhibits) is basically irrelevant most of the time for SARS-CoV-2 infections in the cells it actually infects in humans.

There is one inhibitor of TMPRSS2 mentioned in that paper namely camostat, but it seems it's only approved as a drug in Japan and for other diseases: pancreatitis etc. Wikipedia does cite one small-scale retrospective study of camostat for Covid-19 (but actually conducted in Germany). That paper ends with the predictable suggestion that "Camostat mesylate thus warrants further evaluation within randomized clinical trials."

I also found an older (2017) review on other TMPRSS2 inhibitors, but it's not exactly clear if any of the [other] compounds mentioned (aprotinin, nafamostat, AEBSF, leupeptin, bromhexine hydrochloride, and a few more which only have [long] chemical names) has been tested in any way against Covid-19, although some of these compounds were previously tested against influenzas. So, has any RCTs for a TMPRSS2 inhibitor been even started for Covid-19? Or is there some (other) reason to think such drugs would likely not be useful against Covid-19, so it makes no sense to test them?

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Yes, there are a number of trials.

16 of these studies are recruiting, 1 study started in April 2020, is no longer recruiting and will finish in May 2021 and no trials have been completed so far.

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    Based on those it seems camostat and nafamostat (roughly in that order) are the ones most investigated in western countries, with a multi-site trial in the US (and also a similar one in France and one in Germany) for camostat .
    – Fizz
    Feb 12 at 15:55
  • @Fizz Please go ahead and post a more elaborate answer using my links - I don't have enough time at my hands to do it more rigorously. (Maybe this answer should have been a comment, tbh)
    – Narusan
    Feb 12 at 15:56
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    If someone posts a more elaborate answer using your data, flag this answer for me and I'll convert it to a comment.
    – Carey Gregory
    Feb 12 at 19:46

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