While there is no specific cure for Covid-19, we do have a number of drugs available that are proving useful in managing the infection. Others, considered promising at the start of the pandemic, were subsequently downgraded and set aside. The drugs that are used today, based on the severity and stage of the infection, aim to mitigate the effects of the disease and facilitate the recovery of patients. But not always and not all.
The antivirals failed or almost
They were the first choice at the start of the pandemic, but nearly all of them proved useless or even harmful in clinical trials. Liponavir / ritonavor, for example, are two drugs used against HIV. They were used in the early stages of the epidemic but Aifa decided to suspend the authorization for off-label use because both proved ineffective. Same fate for the “old” antimalarials chloroquine and hydroxychloroquine, today also used in the treatment of some autoimmune diseases.
Covid: drug hunt on the dark web
by Tina Simoniello
In particular, hydroxychloroquine has become very popular especially after former US President Donal Trump publicly praised its effects. But there is no evidence of its effectiveness. The World Health Organization then definitively rejected it, along with chloroquine. The same goes for the Italian Medicines Agency (Aifa). The only one antivirals “Survived”, at least in part, the clinical tests is remdesivir. It is a drug developed against Ebola, rejected by the WHO, but which continues to be used only in selected cases. More precisely, it is administered in patients who are in the so-called “second phase” of the infection, that is, in the presence of symptoms that tend to worsen.
The new promise of monoclonal antibodies
Approved a few weeks ago, they are considered among the most effective weapons we have today against Covid-19. At the moment the only ones on the market are the Regeneron cocktail and Eli Lilly’s drug. Regen-Cov is the cocktail of monoclonal antibodies made famous for having also been used by the former US president, Donald Trump. Manufactured by the American pharmaceutical company Regeneron, it is based on casirivimab and imdevimab antibodies. The first was isolated in a Singaporean patient and the second was obtained in the laboratory by inserting the coronavirus spike protein into the organism of a generically modified mouse.
New drugs against Covid, the computer will find them
by Paola Mariano
According to the research results, it would be able to significantly reduce the viral load and reduce the risk of contracting the infection by 50 percent. This has opened up the possibility of using this cocktail as a “passive vaccine“, pending greater availability of anti-Covid vaccines. The data indicate that the drug can at the same time reduce the viral load of infected individuals. Bamlanivimab is the monoclonal antibody authorized for emergency use as a treatment for high-risk patients with mild to moderate Covid-19 in the United States and other countries around the world. Produced by Eli Lilly and Company, the studies show 72 percent effectiveness in reducing the risk of hospitalization for patients with moderate symptoms.
Monoclonal antibodies against Covid: the first Italian drug by the summer
by Noemi Penna
Bamlanivimab and etesevimab is the combination of Eli Lilly antibodies that studies show to be able to reduce the risk of hospitalization and death from Covid-19 by 70 percent. The two monoclonals were tested in high-risk patients recently diagnosed with Covid-19. The results show that they are also able to reduce viral load and accelerate the resolution of symptoms.
Corticosteroids “turn off” inflammation
They are synthetic drugs that mimic the action of natural hormones. They have anti-inflammatory properties and regulate the metabolism and immune system activity. They are widely used in the clinic for chronic inflammation, allergic reactions and autoimmune diseases. Despite the initial hesitations, due to the few conflicting studies on the use of corticosteroids for the treatment of viral and bacterial infections, the Aifa then indicated their use in some selected cases.
Covid therapies: never do it yourself cortisone
by Daniele Banfi
Precisely “in hospitalized subjects with severe Covid-19 disease who require supplementation of oxygen, with or without mechanical ventilation (invasive or non-invasive)”, reads the indications. In particular, dexamethasone is effective in patients suffering from overactivation of the immune system, the last phase of the disease that sees the greatest damage coming no longer from the virus but from the immune system. The drug therefore extinguishes the excessive inflammation that the immune system puts in place to defend itself from Covid-19 and for this reason its use is indicated in severe patients and not in mild / moderate ones, in which its intervention would reduce its effectiveness. of the immune system in attacking Sars-Cov-2.
Encouraging signs from hyperimmune plasma
It is the treatment that consists in using the plasma of patients recovered from Covid-19, therefore rich in antibodies against the new coronavirus. There are encouraging signs from the clinical studies conducted on this therapy. The latest come from a study published in the New England Journal of Medicine, according to which hyperimmune plasma would have a positive effect on patients if used during the first 72 hours of hospitalization, and, in the case of a high antibody titre, be able to save lives because it is also effective on elderly people. In Italy, the Higher Institute of Health has launched the “Tsunami” study which has the very purpose of evaluating this therapeutic option, but the data have not yet been published.
Heparin “tricks” the virus
Among the treatments of Covid-19 infection there are very encouraging data for enoxaparin sodium. It is a’heparin low molecular weight and is one of the most widely used anticoagulants for the prevention and treatment of venous and arterial thromboembolism in subjects undergoing surgery or bedridden. Its use is being evaluated to counteract coagulation alterations and thrombotic complications in Covid-19 patients. The mechanism of action of the anticoagulant consists in attracting the virus that attaches itself to the drug molecule: the virus is thus “deceived” and, instead of attacking healthy cells, attacks the heparin.
Longform
Covid 19: treat it safely at home. The guidelines of the Ministry of Health
by Valentina Arcovio
Heparin can be used immediately, even at home, in patients who have thromboembolic cardiovascular risk factors. It can be used as a prophylaxis at low doses or in the treatment at higher doses, because the patient already has severe symptoms that may lead to the need for mechanical ventilation.
Tocilizumab, still mixed results
It is an inhibitor of interleukin 6, one of the most important cytokines involved in the inflammation that develops in the second phase of the disease. It is used as a treatment for rheumatoid arthritis and cytokine release syndrome that can occur with Car-T cell therapies, which are useful for fighting certain types of blood cancers.
Covid, interferon beta for the home care of patients over 65
At the start of the pandemic, tocilizumab was seen as very promising, but from the studies conducted so far we have little evidence of its effectiveness at any stage of the disease. In the Recovery trial, however, the molecule seems to have proved useful in hospitalized patients with oxygen needs. Analyzes showed that tocilizumab was able to reduce mortality and the use of mechanical ventilation. Today tocilizumab, in Italy, can only be used in clinical trials.
Anakinra extinguishes the “cytokine storm”
In a recent clinical study published in the Lancet Rheumatology journal and conducted by the Vita-Salute San Raffaele University, it emerged that the interleukin IL-1 inhibitor, called anakinra, is able to turn off the inflammatory cytokine storm that affects patients. with severe forms of Covid-19. The study compares, for the first time, the efficacy of anakinra with the IL-6 inhibitors tocilizumab and sarilumab. According to the results, unlike the latter, only anakinra produced a substantial reduction in mortality: the cytokine to be targeted is precisely IL-1. The study also demonstrates the need to intervene in a timely manner, since patients treated first. For this reason, an international randomized trial has now been launched which aims to add evidence about the efficacy and safety of anakinra in patients with Covid-19.
.