Merck’s Molnupiravir, Zydus Antibody Cocktail and Glenmark Nasal Spray are among more than 20 new drugs at different stages of drug trials or approvals in India to treat Covid-19.
While the market for these drugs is not huge at the moment due to a drop in Covid-19 cases and extended lead times, experts believe these drugs will help control future waves and protect people. with low immunity.
Health experts say the drug pipeline will play a crucial role in India’s fight against the novel coronavirus. They argue that Covid-19 vaccines would only provide immunity against serious illness or death. However, one can still catch an infection and develop complications or long-term side effects from the disease.
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In addition, some people may not be able to generate an immune response despite vaccination. Other vulnerable groups such as the elderly, immunocompromised patients or those for whom vaccine injections are not recommended are also at risk. Experts believe that covering 100% of the population with vaccines is highly unlikely and having treatment for the coronavirus is “very important”.
For example, while smallpox was eradicated decades ago, the drug against it, Tecorivimat, was approved by the US regulator in 2020 although no cases of smallpox have been reported for many years.
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“These first generation vaccines do not provide sterilizing immunity as effectively. They prevent serious infections. This means that some of those who are vaccinated may still get sick with mild illness, leading to further complications or causing a long Covid, ”said Dr Raman Gangakhedkar, former scientist at ICMR, adding that we are still learning. more on the long term aspect. effects of Covid.
“In addition, non-response to the vaccine is also observed in some people. In addition, 100% vaccination coverage is a utopian goal. Therefore, there will always be some who are vulnerable to infection, ”said epidemiologist Dr Gangakhedkar, who was the face of the Indian Council for Medical Research (ICMR) during the government briefings on Covid-19. last year.
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The top scientist also urged to prepare for a scenario in which a mutant strain immune to the vaccine begins to evolve and spread.
“Imagine if a more potent mutant escapes the vaccine-induced immune response and starts to spread. Effective antivirals will be needed to reduce mortality as well as associated morbidity. Better to be ready with an approved drug than to work on it after such a mutant strikes, ”he said.
Another health expert, Dr Chandrakant Lahariya, physician and epidemiologist, echoed the observations. He said that while there have been immense investments and successes in the research and development of Covid-19 vaccines, the promising experimental therapies have not met with the same success.
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“The level of investment and interest in research and development of Covid-19 therapies has been lower than it should have been. One of the biggest risks in clinical trials of Covid-19 therapies is that once cases are identified, many companies might not see a large market for further research and testing. It would be a mistake, ”he said.
Experts believe the SARS CoV2 virus would stay with humanity and continue to cause Covid-19 at a relatively low rate.
“While the world needs Covid-19 vaccines, the world also needs proven and effective Covid-19 therapies,” Lahariya said.
List of drugs in the pipeline
Oral antiviral treatment molnupiravir from US pharmaceutical giant Merck and Ridgeback Biotherapeutics, which has been shown to reduce the risk of hospitalization or death by around 50%, has been tested in India through its partner companies Cipla , Dr Reddy’s Laboratories, Sun Pharmaceutical Industries and Torrent Pharmaceutique.
Based in Ahmedabad, Zydus Cadila is the only Indian company that claims to have developed a cocktail treatment neutralizing monoclonal antibodies. A similar drug made by Swiss drug maker Roche was administered to former US President Donald Trump when he contracted Covid-19. The drug is currently undergoing Phase I / III trials in India.
Pfizer’s Ritonavir, an investigational antiviral drug, is designed to stop the virus early, before it has a chance to replicate extensively. This could prove to be a potential therapy to prevent symptomatic illnesses in those who have been exposed and to inhibit the onset of infection in others. The Company’s other investigational oral antiviral, PF-07321332, has received the green light for Phase II and III trials.
Mumbai-based Nitric Oxide Nitric Oxide Spray for Covid-19 from Glenmark has been approved for large-scale trials in India. The study on the spray in the UK suggested that it is very effective in lowering the viral load in Covid-19 patients and reducing transmission.
NIPER’s Life Viro Treat, a nebulizer-based therapy for respiratory viral infections, is also being tested against Covid-19. The National Institute for Pharmaceutical Education and Research (NIPER) is a government-run institute that has partnered with Supreme Industries to conduct trials.
Silmitasertib, a drug that acts on the CK2 protein kinase pathway and is believed to have high clinical potential to treat Covid-19, has been presented for trial approval by PAT Pharma. Its developer has announced encouraging results. The CK2 inhibitor works by potentially preventing active viral replication in infected cells to prevent the spread of infection. The drug may also reduce the body’s overactive inflammatory response to Covid-19.
India’s leading scientific research organization, CSIR, has conducted phase III trials of umifenovir, a drug primarily used for the treatment of influenza in China and Russia.
Several other drugs, including Niclosamide from CBCC Global Research, Thymosin -1 Injection from Gufic Biosciences, purified aqueous extract of Cocculus hirsutus from Sun Pharma, and Imatinib Mesylate from Syngene have been approved for trial or are in progress. in the process of providing more details to request approval.
Seeking government support
Governments should actively support clinical trials of Covid-19 therapies, health experts say.
“In fact, the government should form a type of collaboration between government and industry similar to that which has been done for vaccines,” Lahariya said. “In any case, as the number of Covid-19 cases decreases, it would take more time to complete clinical trials (because the number of volunteers for these trials could be reduced). This is another reason why these trials should be supported.
Dr Gangakhedkar echoed a similar concern. “Trials will now last longer, which means companies will need more time to complete trials and spend more as well. But they must continue. I think the government could help the drug companies keep the trials going. It would be a worthwhile investment.
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