The antiviral molnupiravir, developed by MSD (known as Merck, in the US) in partnership with Ridgeback Biotherapeutics for the treatment of Covid, should maintain proven efficacy in tests even against new variants of the virus, including omicron, according to the manufacturers.
In October, the laboratory responsible for the drug announced that the drug could reduce the number of hospitalizations and deaths by up to 50%. In the following month, updated data indicated a smaller reduction, of 30%, in these cases.
Molnupiravir works by preventing the replication of the coronavirus by attacking one of the enzymes used in its reproduction.
According to the laboratory, the treatment was shown to be effective against the gamma, delta and mu variants, and the same is expected from the response to omicron, since the drug’s mechanism of action should not be affected by mutations in the new strain.
The drug is already approved for use in the UK and is awaiting approval in the US. In Brazil, MSD asked Anvisa to authorize the emergency use of molnupirvir in November and is awaiting approval.
Other drugmakers developing drugs against Covid have already said their drugs are likely to remain effective against the omicron variant. This is the case of Paxlovid, from Pfizer, which, according to the manufacturer, reduced hospitalizations and mortality caused by the coronavirus by 89% and maintains protection against new variants.
There were fears that monoclonal antibody-based therapies might be more susceptible to the spike protein changes seen in the new variant.
But last Tuesday, the manufacturer GSK announced that the treatment it developed in partnership with the American group Vir Biotechnology is effective against all mutations of the omicron.
The drug, called sotrovimab, is a monoclonal antibody that acts directly on the virus protein, mimicking the action of human antibodies.
The drug was approved by Anvisa (National Health Surveillance Agency) in September this year.
Another therapy based on monoclonal antibodies, the cocktail Regn-Cov2, manufactured by Roche in partnership with Regeneron, has also been evaluated for its effectiveness against the omicron variant.
In a statement, Regeneron said that there is still no evidence that the new strain dribbles immunity induced by vaccines or monoclonal antibodies, but first analyzes indicated a reduction in the drug’s ability to neutralize the virus.
Regn-Cov2 is a cocktail made up of the antibodies casirivimab and indevimab.
The promise of oral therapies that can be administered in the first days and prevent the disease from worsening brings hope to Covid’s patients, especially the elderly, for whom the available vaccines are less effective, and the immunocompromised, who sometimes cannot do it. use of immunizing agents.
“Acute viruses have always been a big challenge. We’ve lived with them for years, with flu, dengue, chikungunya. We’ve never had a medication really capable of changing the patient’s clinical response”, says Estevão Portela Nunes, deputy director of clinical services at the Evandro Chagas National Institute of Infectious Diseases.
The challenge will be to guarantee access to new medicines in the first days of the disease and to coordinate this access with vaccination, says Nunes. “The first barrier is, and must be, the vaccine. The drug appears as a second barrier, for those who are not able to benefit so much from it.”
REMEDIES AGAINST COVID IN BRAZIL
Since the beginning of the pandemic, Anvisa has authorized 109 drug study protocols against Covid in Brazil. The number does not include vaccine studies against the disease.
So far, Anvisa has approved the use of six medications for emergency use in the country. They are: remdesivir, an injectable antiviral for hospital use indicated for patients with pneumonia; monoclonal antibodies casirivimab and imdevimab (developed by Roche and Regeneron), banlanivimab and etesevimab (Eli Lilly), regdanvimab (Celltrion Healthcare) and sotrovimab (GlaxoSmithKline Brasil) and baricitinib (Eli Lilly).
Among the drugs being analyzed by Anvisa, in addition to molnupiravir, from MSD, are tofacitinib, used to treat arthritis. It is an immunosuppressive agent that inhibits proteins that trigger inflammatory processes. The drug was tested in a clinical study conducted by the pharmacist in partnership with the Albert Einstein Hospital.
Among the drugs with studies authorized by Anvisa in progress in the country, there are also alternatives such as medicinal cannabidiol, whose effects are evaluated in patients with the so-called long Covid. The condition is characterized by the continuation of complications of the disease for months after diagnosis. The phase three research, with human volunteers, is coordinated by USP’s Hospital de Clínicas.
TYPES OF REMEDIES TESTED AGAINST COVID-19
- anti-inflammatory Fight the inflammation caused by the virus. They are administered in more advanced stages of the disease, such as admission to the ICU. E.g.: dexamethasone
- Antivirals Prevent virus replication. They should be administered orally, at home, three to five days after the first symptoms. E.g.: Paxlovid, molnupirvir
- monoclonal antibodies They act directly on the virus protein, mimicking the action of human antibodies. Indicated in the early stages of infection, via injection, to prevent the disease from getting worse. E.g.: Regn-Cov2 (casirivimab and indevimab antibody cocktail, by Roche and Regeneron)
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