- Treatment of COVID-19 may become much simpler in the near future.
- The next generation of treatments can come in the form of pills, nasal sprays or inhalers.
- The most promising candidates are antiviral pills developed by pharmaceutical giants Merck, Pfizer and Roche.
COVID-19 may become much easier to treat in the near future.
To date, physicians have relied on expensive, invasive drugs that are limited in supply and often complicated to administer. But biotech and pharmaceutical companies are now working on much simpler treatments that people could take like pills, nasal sprays and inhalers.
Last week, Merck and Ridgeback Biotherapeutics announced that their antiviral pill was shown to reduce the risk of hospitalization or death among adults with mild to moderate COVID-19. The companies said they would ask the Food and Drug Administration (FDA) to approve the pill for emergency use as soon as possible.
So far, the FDA has fully approved only one treatment for COVID-19: the antiviral drug remdesivir, which is administered by injection. The drug has been shown to shorten the recovery time for inpatients.
The FDA also approved the acute use of monoclonal antibodies, drugs that help prevent people with mild or moderate symptoms from developing severe COVID-19. These come in two forms: infusions or injections.
However, pills or sprays may make it easier for people to treat COVID-19 symptoms right away, perhaps without having to visit hospitals. Pills are also likely to be cheaper than antibody infusions, which are free for patients but cost the U.S. government more than $ 1,000 per day. Dosage.
The following drugs have shown the greatest promise in trials as potential COVID-19 treatments. However, none of them are a substitute for vaccines.
Antiviral pills can reduce the risk of hospitalization
Avoiding severe COVID-19 symptoms can ultimately be as simple as taking a few pills.
Merck’s antiviral, molnupiravir, was originally developed as a treatment for influenza. Now, too mild to moderate COVID-19 is being evaluated in a study of nearly 1,900 volunteers. So far, the pill has halved the risk of hospitalization or death among a small group of 385 people, Merck announced Friday. Participants took a total of 40 pills: four capsules twice daily for five days.
The pill belongs to a class of antiviral drugs called nucleosides, which try to block the virus from replicating inside cells.
Two other companies, Roche and Atea Pharmaceuticals, are also jointly developing a pill pill nucleoside. The drug, called AT-527, was shown to reduce the amount of virus present in inpatients with moderate COVID-19. However, the survey was small – about 60 people – so Roche is waiting for data from a survey of almost 1,400 people, which could be available before the end of the year.
Not all potential COVID-19 pills are the same
Other companies are developing antiviral pills called protease inhibitors that target an enzyme involved in the viral replication process.
Pfizer is testing such a drug in combination with a low dose of another antiviral drug that slows the breakdown of Pfizer’s drug so that it lasts longer in the body. The company started a 3,000-person survey in July and hopes to get data by the end of 2021.
Meanwhile, a protease inhibitor from the Japanese drug manufacturer Shionogi could help people with mild or asymptomatic infections. The company began a late-stage investigation in September.
Two smaller biotech companies — Pardes Biosciences and Enanta Pharmaceuticals — are also working on their own protease inhibitors, but they are far from late studies. Pardes launched a trial of 110 people in August to test its pill, and these results could be ready by the end of the year. Enanta hopes to launch the first test of its pill in humans in early 2022. The company has previously developed a treatment for hepatitis C.
Nasal sprays can be helpful immediately after exposure to the virus
Coronavirus first invades the body through the nose, eyes and throat, so researchers believe there is an advantage in administering treatments directly in these areas.
For example, nasal spray can kill or weaken the virus in the upper respiratory tract before it spreads to the lungs, where it is likely to cause the most damage.
A May study showed that a nasal spray from the biotech company SaNOtize reduced the amount of virus present among 40 people with mild COVID-19. The spray uses a colorless gas called nitric oxide, which is found naturally in the body. Israel now offers this drug in pharmacies.
Another company, IGM Biosciences, is developing a nasal spray containing an antibody designed to neutralize coronavirus. The spray reduced the amount of virus in the lungs of the mice, but researchers do not yet know if it will be effective in humans. Zhiqiang An, a professor of molecular medicine involved in the research, told Nature that the spray could eventually serve as an emergency treatment after someone has been exposed to coronavirus.
Inhalers could shorten the cure among inpatients
A few inhaled COVID-19 drugs also show promise, although more research is needed.
In a small study of about 100 hospitalized COVID-19 patients, a Synairgen inhaler was found to increase the odds of improvement and lead to faster recovery times compared to patients receiving placebo.
The inhaler uses a naturally occurring protein to stimulate the immune response in the lungs. Synairgen expects results from a late-stage study of inpatients in early 2022.
A large study also found benefits of inhaled budesonide, a generic anti-inflammatory drug that treats asthma and chronic obstructive pulmonary disease. A UK study of high-risk COVID-19 patients found that budesonide helped them recover about three days faster than those receiving standard care. However, the same study found that budesonide did not significantly reduce hospitalizations or deaths.