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Current COVID-19 medications save patients, but they have their limitations. No wonder that numerous clinical trials are underway to increase the treatment options for a new disease. New substances are being tested as well as old drugs – in various dosing methods and combinations. There are reasons for optimism.
- The European Medicines Agency has so far approved eight substances that can be used to treat COVID-19
- However, work on new drugs is still ongoing. Hundreds of promising clinical trials are underway around the world. Perhaps new, effective antiviral drugs will be in use this year
- Many of the substances on which the tested drugs are based are used to treat other conditions, such as pancreatitis and depression
- You can find more such stories on the TvoiLokony home page
As experts recently reported in the famous scientific journal “The Lancet”, vaccination against COVID-19 saved about 20 million lives. However, specialists dealing with the pandemic emphasize that it is also necessary to attack it from the other side – in addition to vaccination, well-functioning drugs are necessary.
There are several reasons, including:
- Post-vaccination immunity declines over time and new virus variants make matters worse.
- People with a weakened immune system do not respond as strongly to vaccination as healthy people.
- Not everyone has access to vaccinations, and many people have chosen not to take them.
- In addition to saving the lives and health of people at risk, well-functioning drugs also relieve strained health care.
– The main means of fighting a pandemic is prevention, and the main tool is vaccination. However, new drugs can fill the gap where vaccination will not work – for new variants, among others, ‘said Prof. Taher Entezari-Maleki, expert in clinical pharmacology at the Iranian University of Tabriz for another prestigious journal Nature.
What is COVID-19 being treated now?
Medicine is not powerless when it comes to helping people suffering from COVID-19. For example The European Medicines Agency has approved eight measures to treat this disease. Six of them interact directly with the virus. Evusheld contains two monoclonal antibodies (drugs belonging to the group of biological, i.e. produced with the participation of living organisms) that attack the spike protein, and this prevents the penetration of virions into the cells. Regkiron’s, Ronapreve’s and Xevuda’s drugs work in a similar way. In turn, Paxlovid and Veklury block enzymes necessary for the virus to replicate.
An important part of the therapy is controlling the immune system, which sometimes becomes hyperactive with this infection and, in defending itself, destroys the patient’s tissues. Kineret and RoActemra, previously approved for the treatment of other diseases (including rheumatoid arthritis), are used to suppress these reactions. Lagevrio and Olumiant are waiting for release for sale. The first misleads the genetic material of new virions, and the second is an immunosuppressant (silencing the immune system) designed to soothe inflammation.
Successes and Limitations
The introduction of these substances is a huge step forward. For example, in the study cited by the European Medicines Agency, Paxlovid caused a decrease in the number of deaths or cases requiring hospitalization from 6,3%. up to 0,8 percent At the same time, no patient who took this drug died (there were only hospitalizations), and in the group receiving the placebo, 12 people died out of just over a thousand.
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However, it must be remembered that each drug has its limitations. For example, the aforementioned Paxlovid interacts in numerous ways with various other agents, which sometimes precludes its use. Some results suggest that molnupiravir may be capable of damaging human DNA. Therefore, for example, it should not be used during pregnancy.
There is also a constant risk that the virus will become resistant to drugs. Therefore, there is a need for further measures, operating in various ways, that will expand the arsenal of medicine. It is also worth making them easier to use, as currently many of the substances used are administered in hospital conditions.
Hundreds of research
Scientists, however, have a lot of optimistic news. According to an article published in Nature, the world may wait for a “flood of new drugs” against SARS-CoV-2. As experts point out, Hundreds of clinical trials (involving humans) on new substances are already underway and most likely this year will be the best treatment for COVID-19.
For example, about 200 monoclonal antibodies are tested. Approx. 40 concerns substances similar to molnupiravir, 180 – drugs similar to Paxlovid. These include the late-stage Japanese S-217622 developed in Japan, which is also expected to be potent against the Omikron variant.
Drugs that attack other targets, including human proteins needed by the virus during its life cycle, are also proven. Some of them have already been used in other diseases. One can mention the already known anticancer drug – plitidepsin, which is already in the third phase of clinical trials. This substance interferes with the action of the human protein, which SARS-CoV-2 uses to multiply.
Another promising drug is Kamostat, which is currently being used, inter alia, in in the treatment of pancreatitis. As it turns out, it attacks a protein that helps various coronaviruses enter cells. The researchers point out that drugs targeting human proteins used by the virus have the advantage that it is more difficult for the germ to develop resistance to them. And that would be a big trouble.
«We don’t have many antivirals. So if we lose even one of them, it will be a disaster » Peter Horby, an expert at the University of Oxford, told Nature.
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New combinations and methods of administration
Among the drugs already used in other diseases and tested for use in COVID-19, there are also anti-parasitic and antidepressant substances.. But new drugs or their new uses are not everything – they also test new combinations of different agents and check how they work together.
The administration of drugs at different stages of the disease is also tried. This is important because, for example, treating all patients at an early stage involves enormous costs, and unfortunately, it is not known who will develop the severe form. If the drug were to be effective when administered at a later stage, it would mean huge savings, and this in turn – better availability of drugs, the stocks of which are limited, especially in poorer countries.
As you can see, a lot is happening. This may seem chaotic, and to some extent it is, as the experts themselves note.
“In the midst of this chaos, it’s hard to predict which of the many treatments currently being tested will be successful. The whole situation is like a turbulent vortex and the rules of the game are constantly changing. It’s hard to pinpoint a winner “, said Paul Verdin, an expert from the British pharmaceutical business analysis company, Evaluate, for Nature.
However, if you consider the effort involved, you can be hopeful that there will be winners and maybe even many.
Marek Matacz for Zdrowie.pap.pl
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