It’s the news of the moment: the discovery of a pill that would change the natural history of the Covid-19 pandemic. The source is serious and we all hope that the news is not fake news. We hope so and await confirmation from the regulatory bodies that have this responsibility: Fda, Ema, Aifa. It is up to them to tell us if it is true that the new drug can cure the virus that has killed millions around the world in almost two years. It’s about a pill that halves hospitalization times in the event of a coronavirus attack and drastically reduces the risk of dying, also for this reason we are talking about 50% of positive results.
We are talking about a drug born in Merck, one of the largest pharmaceutical companies in the United States. A discovery that is made public after a series of experiments and checks. It is molnupiravir, an antiviral pill for which Merck sought authorization from the American Food and Drugs Administration after completing the phase 3 studies. The number of deaths in patients who took the new pill was half that of the control group who was given only a placebo.
Specifically, 7.3% against 14.5%. Once the diagnosis of Covid infection has been made, the drug must be taken twice a day for 5 days, without any serious or dangerous side effects for the patient. It is the first drug that responds to these three fundamental characteristics: therapeutic efficacy, ease of administration, absence of negative consequences. Not only. The sample was selected by choosing patients who presented, in addition to Covid, at least one other important symptom, such as diabetes, obesity and / or advanced age. The drug, the company said, has shown “consistent efficacy” against numerous variants of the new coronavirus, including the Delta variant.
These are conditions that make the use of this drug particularly interesting: adaptability and resilience even in objectively serious conditions of discomfort. Merck wanted to experiment with the drug by focusing on the complexity of the patients to whom it is administered, precisely to guarantee its effectiveness.
Obviously, this discovery adds to all the results obtained with the intense vaccination campaign that is being carried out throughout the world, to prevent infection and contain the pandemic.
However, it represents an important turning point both for still unvaccinated patients who contract the virus, and for those patients already vaccinated who in any case incur the disease. The ease of administration and the standardization of the procedures necessary to package the new drug allow to overcome the complexities related to monoclonal antibodies, which until now represented the only therapy of proven efficacy.
The only real difficulty of the new antiviral therapy is the precocity of the diagnosis, which must be as timely as possible. The therapy is in fact ineffective in the case of patients hospitalized and arrived after a process of infection already started for days.
It is certainly an extra element of hope. We know well how in medicine many diseases can be defeated only if diagnosed as soon as possible and treated with the right drugs from the first moment: time is always the great ally of treatment and forces all of us doctors to have tools for early diagnosis. Screening, increasingly sophisticated imaging techniques, blood-chemical tests in search of increasingly precise markers: everything contributes to making a drug more effective and therefore to improving the living conditions of a patient. To date, therefore, if this drug is also confirmed in its effectiveness by the American FDA first and then by the Ema and Aifa, we will be able to imagine a treatment of the Covid infection in the classic three stages: pwithdrawal (vaccines), early treatment (molnupiravir) and in more severe or late diagnosed cases, thirdly, monoclonal antibodies.
Having overcome this pandemic phase with all the aftermath that it still entails also on the socio-economic level, we will be able to live with the virus by facing it like other infections; treating the sick without slipping into the risk of having to treat each of them as a dangerous contagion factor to be isolated with quarantines that are increasingly difficult to manage.
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