In search of the star medicine against COVID-19

As long as there is no vaccine, epidemiologists warn that the new coronavirus will have to be lived with. As countries begin their respective de-escalations after different modalities of confinement and quarantine, there is growing concern about the effects that successive waves of SARS-CoV-2 could have on public health and the economy. Distance and hygiene measures, experts warn, are key to flattening the pandemic curve.

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The so-called "new normal", however, is hopelessly accompanied by the daily battle against COVID-19 in hospitals around the world. The goal, in better or worse conditions, is always the same: to save lives. But what is the best alternative to do it? Parallel to the search for a vaccine, a global pharmaceutical race is being developed to find the most effective medicines for treating the sick. The efforts of scientific research are titanic, but the unknowns are still enormous.

The following is a list of the drugs that are most promising against the virus today.

Afivavir (or favipiravir)

Russia has announced the registration of the first specific drug for the treatment of COVID-19: afivavir, developed from the Japanese antiviral favipiravir. This drug is used in Japan against the flu. Its activity is especially intense in the respiratory tract, decreasing the viral load to non-infectious levels. In China, Wuhan University also conducted a study of this drug.

Although it is not marketed in Europe or the United States, Italy has authorized its use. The passage of Moscow implies that from June 11 it will be available in Russian hospitals to carry out 60,000 treatments.

Hydroxychloroquine

Until six months ago, very few had heard of it, but hydroxychloroquine has the dubious honor of having staged the first major scientific scandal of the pandemic. The prestigious scientific journal The Lancet published a study that associated its use with an increased risk of death.

In response, several clinical trials were stopped in an attempt to demonstrate their efficacy against the coronavirus, including that of the WHO. But within days, doubts began to emerge about the study data provided by Chicago-based Surgisphere. The authors of the Lancet and The New England Journal of Medicine studies themselves have called for their withdrawal on suspicion of the data.

Now the WHO has resumed its clinical trial, which in the coming weeks must clarify whether the treatment is safe and effective.

Remdesivir

The European Medicines Agency evaluates the clinical results of the product called remdesivir presented by the American laboratory Gilead Sciences. If given the go-ahead, the countries of the European Union would join the decision made a few weeks ago by the Government of Donald Trump in the United States, which has already authorized this drug on an emergency basis.

Remdesivir appears to be the most promising of the many drugs that have been tried against the pandemic. It is a retroviral that has been experimentally tested in the past against other viral pathogens such as Ebola, Marburg virus, MERS or SARS.

Famotidine

Could a widely available and inexpensive heartburn medication become an effective treatment for COVID-19? A study of a small series of cases published in the journal "Gut" suggests that famotidine could be a good candidate to fight infection with the virus in those patients whose condition does not require hospital admission.

Aplidin

Aplidin is another hope, in this case of Spanish origin, against SARS-CoV-2, although it was initially designed to treat multiple myeloma. Its active substance is plitidespine. Specifically, aplidin does not act on the coronavirus, but on the protein eEF1A, present in the body and used by COVID-19 for its spread.

The bad: Pharmamar itself estimates that the drug won't be available until 2021. The company's CEO, Luis Mora, has nonetheless spoken of "astonishing" results and announced that he plans to bring the trials to the US. He has assured that "the antiviral potency of aplidin is a thousand times greater" than that of Gilead's remdesivir, his great rival in this global pharmaceutical career.

Lopinavir and ritonavir

Lopinavir and ritonavir belong to a class of medications called protease inhibitors. In combination with other medications, these two antiretrovirals are used to treat infection by the human immunodeficiency virus (HIV). The WHO is conducting a clinical trial of the efficacy of these two drugs with interferon beta-1a, a drug used against multiple sclerosis.

On the other hand, a study by the University of Hong Kong suggests that the combination of interferon beta-1b (also against multiple sclerosis), lopinavir, ritonavir and ribavirin (a useful antiretroviral against hepatitis) is more effective in relieving symptoms. and reduce the elimination time of the SARS-CoV-2 virus.

Zotatifine

Zotatifine is on the list of 47 existing drugs that could help fight COVID-19, scientists from the University of California announced this second week of June 2020.

As explained by the laboratory that produces this molecule, eFFECTOR Therapeutics, zotatifine (originally created against cancer) does not attack the virus, but acts on the cells that the new coronavirus hijacks. According to Californian researchers, both zotatifin and ternatin-4 "appear to fight COVID-19 by binding to the proteins that the cell needs to translate and inhibit them."

Source: Enrique Anarte for DW