One tablet to swallow at the first symptoms of Covid , inhibiting the virus that generates it (Sars-Cov-2). Like any popular drug. The US government unveiled its Antiviral Program for Pandemics on June 17, a $ 3.2 billion investment to accelerate the development and testing of antiviral drugs that “block” the disease. The prospect is to expand the availability of treatments and, at the same time, create a platform for the development of new solutions against viruses with a high pandemic potential. The vaccinations they are engaged at an increasingly intense pace in the US, Europe and other Western countries, but the delays that are recorded elsewhere and the proliferation of variants raise fears of a regression with respect to the ambitions to keep the pandemic under control.
Why develop anti-Covid pills, vaccines are not enough?
Antivirals are drugs that fight viral infections or provide protection for a certain period of time. They exert a therapeutic or preventive action, administered orally (in the form of tablets) or with solutions that can be injected (as in the case of Veklury, read below).
The US government’s plan is to broaden the availability of oral medications as much as possible, addressing the disease before it leads to ICU admissions or death. The US administration, the note from the National Institute for Allergy and Infectious Diseases reads, is “committed to identifying treatments that prevent patients diagnosed with Covid to proceed towards worsening the disease and death “, because” oral anti-viral medicines that can be taken at home early in the disease, similar to treatments like the flu, could save lives both here and in abroad and prevent the overwhelming growth of hospitalizations ».
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The role of vaccines
Even if mass vaccinations remain the crucial weapon against the pandemic, a greater supply of drugs would play “a strategic role”, explains Giampiero to Il Sole 24 Ore. Weather in Mazzaglia, associate professor of Hygiene and Public Health at the University of Milan Bicocca. “Since the virus undergoes frequent mutations – he explains – despite the fact that current technologies make it possible to produce effective vaccines in a relatively short time for new variants potentially resistant to the vaccines currently in use, it will be essential to have antiviral drugs available in our therapeutic baggage. to act against an active Sars-Cov-2 infection “. Given that viral replication is particularly active during the early stage of the disease, “these drugs could play a strategic role especially if used before the disease progresses to the hyper-inflammatory state that characterizes the more advanced stages.”
What we know (and have) so far
The only antiviral currently approved byMom, the European Medicines Agency, is Veklury: a medicine developed by the company Gilead Sciences, already used against the epidemic of Ebola. It can only be given by infusion into a vein, with a treatment ranging from a minimum of 5 to a maximum of 10 days and an initial dosage of 200 milligrams (to drop to 100 milligrams in the rest of the treatment). The active ingredient of Veklury is remdesivir, an inhibitor of the viral Rna polymerase enzyme that interferes with the production of viral RNA and prevents its replication.
«The studies – explains Mazzaglia – indicated that the average healing time in patients with pneumonia who required supplemental oxygen therapy treated with the drug was 4-6 days shorter than placebo. Furthermore, the evidence showed a reduction in mortality at 28 days from treatment of 11.6% in treated patients compared to 15.4% in patients with placebo “. The use of the solution, according to data ofItalian drug agency, would have reached two peaks in Italy in November 2020 and March 2021, then diminishing with the entry into force of the vaccination campaign. The World Health Organization itself recommended in November 2020 not to use remdesivir in “hospitalized patients, regardless of the severity of the disease, as there is currently no evidence that remdesivir improves survival.”