E HH Review Of Present Therapies For Covid-19

As the world grapples with new and deadly mutant SARS-CoV2 strains, it would be worthwhile to keep in mind which drugs have been authorized so far, what drugs are in the pipeline, and those that have failed. 


Authorized drugs:

Remdesivir (Veklury)

Regeneron's Remdesivir is an antiviral that is given by intravenous (IV) infusion. On October 22, 2020, the FDA approved remdesivir for treatment of COVID-19 in patients over age 12, weighing at least 40 kg (88 lbs.), requiring hospitalization.  In contrast the World Health Organization (WHO) does not recommend using it for any COVID-19 patients due to a lack of consistent data.

Dexamethasone

Dexamethasone is a common steroid. In the RECOVERY trial, researchers found that there was a lower death rate at day 28 in the 2,104 hospitalized patients with COVID-19 who got 6 mg dexamethasone compared to the 4,321 patients who did not get it (23% versus 26%, respectively). The medication seemed to be most helpful for patients who were on a ventilator or needed extra oxygen. There was no benefit for those with less severe symptoms.

Additionally, based on a meta-analysis that looked at findings from seven different trials, death rates were lower in hospitalized patients who took one of three different corticosteroids — dexamethasone, hydrocortisone, or methylprednisolone — compared to those who took none (32% vs. 40%).   It should be used only in severe, hospitalized patients on a ventilator or needing oxygen.

Casirivimab and imdevimab (REGN-COV2)

Regeneron Pharmaceutical’s REGN-COV2 has been called an “antibody cocktail” because it is made from a combination of two monoclonal antibodies, casirivimab and imdevimab.  Both of these are monoclonal antibodies to the viral S protein, and the goal is to inhibit the SARS-CoV-2 virus from binding to its receptor, ACE2.  Patients who either got 2.4 grams of REGN-COV2, 8 grams of REGN-COV2, or placebo had clearing of symptoms after 6 days, 8 days, and 13 days, respectively after receiving the cocktail. Patients who had not yet developed their own antibodies and had more of the virus in their body saw the most benefit.

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Kurt Benson 1 month ago Member's comment

Excellent read. Highly recommended.

Ketan Desai 1 month ago Author's comment

Thanks

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Ketan Desai 1 month ago Author's comment

Thanks. Your point of placebo is well taken. Often though, it is not true placebo. The design is standard of care plus study drug versus standard of care plus placebo. The patients thus get the minimum of standard of care.