Treatment options for COVID-19
27/02/2020
Remdesivir is one of the drugs that has caused a stir in the news when it comes to treating COVID-19. There are others that are reported to have the potential to inhibit the virus. Find out the latest.
Hot off the press
This week has seen a new surge of updates from the prevention and treatment fronts of the ongoing joint efforts to tackle COVID-19, led by healthcare professionals, scientists and pharmaceutical companies (TIME, 2020). A news report from TIME magazine informed us on 25 February that batches of a new vaccine, that was developed by Moderna Therapeutics, a biotech company based in Cambridge, MA, US, was shipped by the company to the National Institute of Allergy and Infectious Diseases to be used in a phase I study in the US (TIME, 2020; Moderna Therapeutics, 2020).
The same day saw the announcement by the National Institute of Health, US, that a randomised, controlled clinical trial to evaluate the safety and efficacy of the investigational antiviral remdesivir had started. The study commencing at the University of Nebraska Medical Center in Omaha, US, is going to enrol hospitalised adults diagnosed with the virus (National Institute of Health, 2020).
The widely discussed remdesivir
Remdesivir, developed by Gilead Sciences Inc., is an investigational broad-spectrum antiviral treatment that previously showed promise in animal models for treating Middle East respiratory syndrome (MERS) and severe acute respiratory syndrome (SARS), which are caused by other coronaviruses (National Institute of Health, 2020).
Remdesivir was one of the drugs speculated to have potential efficacy against COVID-19 in a commentary in the journal Nature Reviews Drug Discovery, earlier in February (Li and De Clercq, 2020).
Other potential treatment options
In the above-mentioned commentary, the authors argued that drugs approved for other conditions can be repurposed for COVID-19, based on the functional similarities between the virus and the targets of these drugs. More importantly, these drugs have recently shown inhibitory effects on the virus (Li and De Clercq, 2020).
The analysis listed the following agents as possible candidates to treat COVID-19 infection (Li and De Clercq, 2020):
Virally targeted agents:
- Nucleoside analogues:
- favipiravir - approved for influenza treatment
- ribavirin - approved for treating hepatitis C virus (HCV) and respiratory syncytial virus
- galidesivir - originally developed for HCV
- Protease inhibitors:
- disulfiram - approved for alcohol dependence
- lopinavir - approved for HIV
- ritonavir - approved for HIV
- Griffithsin:
A red-algae-derived lectin that binds to oligosaccharides on the surface of various viral glycoproteins, including HIV glycoprotein 120 and SARS coronavirus spike glycoprotein
Host-targeted agents:
- Pegylated interferon-2a and -2b - approved for the treatment of hepatitis B virus (HBV) and HCV
- Small molecule agents:
- chloroquine - used in treatment and prevention of malaria
- nitazoxanide - approved for diarrhoea treatment
Some of these drugs are already being tested against COVID-19 in clinical trials (Li and De Clercq, 2020).
More in development
Existing drugs are not the only option to target COVID-19. On 20 February, Columbia University, US, announced that four of their research teams were to share a $2.1 million grant to develop drugs or antibodies aimed to prevent the virus from replicating (Columbia University Irving Medical Center, 2020). The teams’ approach will be split into four tracks and will use drug screening, enzyme production, synthetic chemistry or antibody isolation from patients to develop new drugs in the following categories:
- protease inhibitors
- polymerase inhibitors
- nucleotide analogues
- monoclonal antibodies
Upcoming:
Data on the clinical course of the disease is accumulating as more and more cases are being reported from around the world. What are the clinical outcomes of newly diagnosed and critically ill patients? What are the pathological findings? Watch this space.
References
- TIME. COVID-19 vaccine shipped, and drug trials start. Accessed February 2020
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