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Large-scale studies have shown that Merck's oral drugs for COVID-19 do not reduce the risk of hospitalization, and small molecule drugs have been questioned
Taking Merck's oral drug molnupiravir could shorten the recovery time for patients, but did not show any benefit of reducing the number of
hospital stays compared to the placebo group.
Can small molecule oral medications for COVID-19 reduce the risk of hospitalization?
According to the results of a recently published large-scale UK clinical trial, Merck's oral anti-Covid-19 antiviral drugs did not reduce the risk of hospitalization and death in high-risk
adults with Covid-19.
Preliminary results from a clinical trial of more than 25,000 people, released Thursday, show that taking molnupiravir, an oral anticoronavirus drug developed by Merck and its partner Ridgeback, can shorten the recovery time
for patients.
But compared to the placebo group, the drug did not show any benefit
in reducing hospitalization rates.
Reduced critical care rates due to Omicron
Chris Butler, a researcher at Oxford University who led the study, said there was "no difference"
between taking the drug and taking a placebo during Omicron infection if hospitalization was relatively low.
But he doesn't think the study was a
failure.
David of the Chinese Academy of Sciences also said in an interview with CBN earlier: "The purpose of drug research and development is to serve
the clinic.
Importance is also important
if the drug is not shown to reduce the risk of serious illness and only shorten the time to turn negative.
Big discounts
.
”
According to the results of previous clinical trials of Monoravir submitted in the United States, the effectiveness of reducing the risk of severe hospitalization of COVID-19 is 50%.
A recent subsequent clinical study showed that the drug's effectiveness in reducing the risk of severe hospitalization for COVID-19 dropped to 30%.
Early clinical trial results for some drug therapies are encouraging, but the results of large-scale clinical trials are disappointing, which is not uncommon during the COVID-19 pandemic, such as remdesivir
.
In the new version of the COVID-19 treatment guidelines released by WHO in March this year, monogravir
is conditionally recommended.
As recommended by WHO, monogravir should only be given to non-severe COVID-19 patients at highest risk of hospitalization, including unvaccinated patients, the elderly, immunocompromised patients, and patients with
chronic diseases.
In March this year, the U.
S.
COVID-19 diagnosis and treatment plan mentioned that the preferred treatment for confirmed patients is still Pfizer's Paxlovid, sostovizumab or remdesivir
.
The use of Monoprevir
should be considered only if the above 3 drugs are not available or there are clinical contraindications (drug interactions, kidneys, liver problems, etc.
).
Although monogravir is not widely used, it has generated more than $5 billion in sales
since the drug was approved.
In the U.
S.
, Merck's monogravir cost about $700 for a course of treatment, up from Paxlovid's $
530.
The latest clinical trial results also put a question mark
on whether the drug can continue to be used in the future.
In fact, since the launch of the new crown pneumonia small molecule oral drug, the doubt has never stopped
.
Even Paxlovid, the world's most widely used Pfizer antiviral drug, is facing skepticism
.
The biggest suspicion of the drug is that some patients experienced a rebound
of COVID-19 symptoms after stopping the drug.
Researchers at the National Institutes of Health (NIH) tried to explain why some patients' symptoms rebounded not because of drugs
.
A small study published Thursday in the journal Clinical Infectious Diseases suggests that a rebound in a patient's symptoms may be linked
to a strong immune response.
The National Institutes of Health (NIH) conducted an in-depth study of 8 COVID-19 patients who had rebounded symptoms and concluded that patients with rebounding symptoms had higher levels of antibodies, so no longer medication was required to reduce the risk of recurrence of
symptoms.
However, the study did not provide a causal relationship
between elevated antibody levels and rebound of symptoms.
Previously, US President Joe Biden and Anthony Faucci, director of the National Institute of Allergy and Infectious Diseases, both rebounded
from the new crown virus symptoms after taking the drug.
Some experts speculate that this is because the drug interferes with the immune response of some patients, but the latest study refutes this hypothesis, arguing that the rebound in patients' symptoms is not caused by
the virus re-replicating in the body after stopping the drug.
However, the researchers say larger, more detailed studies are needed to better understand the real reasons behind the rebound in patients' symptoms, especially in patients whose immune response is suppressed, to assess the efficacy
of long-term use of Paxlovid.
Currently, some countries have approved small molecule drugs
for COVID-19, including Pfizer's Paxlovid.
However, due to the weak pathogenicity of Omicron and the low proportion of severe/critical illness or death, it is difficult to observe the improvement of clinical efficacy of the drug in the clinical stage, which poses a challenge
to the verification of the effectiveness of the drug.
Hong Kong study: Oral administration of COVID-19 drugs reduces the risk of death
After the outbreak of the fifth wave of the epidemic in Hong Kong at the beginning of this year, the Faculty of Medicine of the University of Chinese in Hong Kong and the Li Ka-shing School of Medicine of the University of Hong Kong have provided two oral antiviral drugs for COVID-19 patients; Between February and March, they studied 54,355 patients, two of whom Cheng took oral medication
.
The two universities announced today that a team of researchers found that hospitalized patients taking any of these oral medications had a lower
risk of death than those who did not.
According to the announcement, the two oral drugs are the two-component oral antiviral drug Nirmatrelvir-Ritonavir, developed by Pfizer in the United States, and the "Monapiravir"
of Merck.
The study noted that if a single calculation of belavir could reduce the risk of death by 90 percent, then a single calculation of monapiravir could reduce the risk
of death by 69 percent.
The team noted that while Bellavir is more effective at reducing the risk of death and hospitalization, it is prone to interaction with other drugs and is not suitable for patients who are taking drugs such as anticoagulants or antibiotics; Monapilavir is less
likely to interact with other drugs.
The findings were published in the medical journal The Lancet
.
Tags: COVID-19