DOCTOR IS IN by Dr. Adil Manzoor OP/ED
Shortly after the coronavirus was declared a pandemic, many pharmaceutical companies and scientists swung into developing a cure or ready treatment. Everyone knew vaccines would take too long to develop – we needed something to control the virus in the short term to prevent the stockpile of deaths.
Many drugs and treatment options stepped up – or tried to, rather, as most failed. As time progressed and more people died, there was panic about which drugs could get the coronavirus under control. Some of the drugs mentioned showed plausible and mixed results, like hydroxychloroquine, while others were just crazy, like Ivermectin. Note that both are not recommended for treating the virus.
But it was clear that we were desperate for an effective treatment. Even now that we have the vaccines, there are just so many unvaccinated people for us, as a planet, to be considered safe from the virus. Don’t let me even get into the fact that variants of the virus are emerging around the globe. Or maybe I should.
The longer the virus persists among us, the higher the chances of new variants and strains developing. Some of these variants, like Delta, will prove to be troublesome and, who knows, may figure out how to beat our vaccines and drugs.
The need for antivirals is more pressing now more than ever. As the name strongly implies, antivirals are drugs that are used against viral infections. They may either kill the viruses, alleviate the symptoms of the viral infection, or shorten the length of the illness.
Antiviral drugs can be classified into two, namely antiviral therapy and antiviral pills. The former is available in many hospitals today and is usually reserved for the more serious cases of the coronavirus. Antiviral therapy requires the assistance of a health practitioner and is typically given intravenously.
The problem is this form of treatment is quite expensive and also inaccessible to the general population. This is where antiviral pills come into the discussion. They can be purchased in pharmacies and self-administered at home, just like your regular Tylenol. That will be a gamechanger if perfected, right?
Well, I have some good news. Britain has approved molnupiravir, marketed as Lagevrio, as the first antiviral pill for the coronavirus. This drug, developed by Merck and Ridgeback Therapeutics, acts by inhibiting the replication of the virus.
Metabolites of the drug are picked up by the RNA polymerase and incorporated into the viral genome. Here comes the fun part. Incorporation of this metabolite creates errors in the virus’s genetic code, which build up to form an “error catastrophe.” Eventually, viral replication ceases.
The mechanism of action of this drug is said to be so powerful the virus may never become resistant to it. In fact, the drug was named after Mjolnir – Thor’s hammer. For context, Thor is the god of thunder, and that probably tells you all you need to know about how highly the drug is regarded.
There’s another antiviral making the news, and that’s Paxlovid, developed by Pfizer. While the drug hasn’t been approved yet, it looks very promising. This drug also inhibits viral replication but in a different manner to Lagevrio. Paxlovid disrupts the functioning of protease, which is an enzyme critical to viral functioning.
There are still tests to be run on Paxlovid before it is approved yet, though. And I don’t expect this drug to be approved until 2022. But at least there’s something to look forward to. There are other antivirals around the block, but none has been approved yet. Again, 2022 will probably be the year antivirals make their grand entrance in the war against the virus.
I expect the CDC to make some announcements soon regarding the new antivirals. Hopefully, it’s good news. Till then, though, we still need to get vaccinated and keep the virus rom spreading.
Later, folks. Stay safe.
This article was written by Dr. Adil Manzoor DO, a Board Certified Internist & Board Eligible Pediatrician, who works as a Hospitalist, and Emergency Room Physician. He is also the current President of Garden State Street Medicine, a non-profit organization whose sole purpose is to provide free preventive and acute urgent care services for the homeless. He is also the co-founder of his own unique medical practice Mobile Medicine NJ.
References
· https://theconversation.com/amp/merck-v-pfizer-heres-how-the-two-new-covid-antiviral-drugs-work-and-will-be-used-171247
· https://www.nature.com/articles/d41586-021-03074-5
· https://www.webmd.com/lung/antivirals-covid-19
