Here are the new drugs coming against Covid-19. Should the third dose and the vaccine be given to children? Word to the expert
In the United Kingdom, the drug agency has authorized the first anti-Covid pill, produced by the pharmaceutical company Merck, and Italy is taking action to make the drug available pending European drug approval (Ema). But the race for new oral drugs against SarsCoV2 virus infection also sees the giant Pfizer take to the field, which presented the data of a new antiviral pill that proved 89% effective in preventing hospitalizations or death. To these drugs are added the monoclonals which, depending on the case, are already administered in hospitals.
Benedetta de mattei interviewed Roberto Cauda – Full Professor of Infectious Diseases and Director of UOC Infectious Diseases – A. Gemelli University Hospital Foundation IRCCS of Rome to take stock of the new drugs against Covid-19 and those on the way.
How will these drugs affect vaccines?
These drugs are the other side of the coin for safe housing, vaccines and we cannot confuse the two. The vaccine prevents infection, disease in those who are not sick and therefore has an area of protection, in terms of public health, lift. Vaccination could change the course of the pandemic in the sense that, although we are concerned about the increase in infections, the type of life we can lead is very different from last year. The drug is useful for those who get sick but seek people to try to make sure they do not get sick thanks to vaccines. Thinking of not getting vaccinated because there is a drug is not something that can be proposed in medicine.
What role do these new drugs play?
Therapy is very important, when this new virus came out we all found ourselves unprepared as always happens when there is a disease, in this case viral, for which there was no vaccine and no drug. Some drugs are therefore placed with varying luck during the first wave, drugs that in fact did not have the capacity that would have been necessary for treatment.
At the end of it all we saw that in the most advanced phase today there are a series of drugs that work but we know that the real “battle” takes place in the initial phase, that is of the viraemia, and to be able to fight correctly you need to have drugs effective. The first to be introduced are the just monoclonals that have been talked about so much.
Monoclonal
In terms of possible monoclonals for the treatment of Covid-19, an important step forward will soon come. In fact, the release of intramuscular injectable monoclonals is “imminent”, in order to facilitate home care. This is not a small novelty if we consider that their use is currently not so frequent for logistical reasons as they are currently used only in hospitals and intravenously.
Merck’s Molnupiravir Pill
It is an antiviral drug that in the phase 3 clinical study (on 775 patients) has been shown to reduce the risk of hospitalization and death in adult patients with mild or moderate Covid by 50 percent (not vaccinated) but at risk of serious illness (for obesity, old age, diabetes or cardiovascular disease). Molnupiravir works against viral polymerase, an enzyme that the new coronavirus needs to replicate in the body. The drug blocks Sars-CoV-2 without calling into question the immune system. It goes administered orally, four pills a day for five days and it’s particularly effective when used in the early stages of infection. Both for monoclonals, both for this drug and for what will come from Pfizer the problem is the precocity of the administration, that it must occur to be fully effective within five days of the onset of symptoms. This is clearly a time limit; these drugs should also not be used indiscriminately but where there are situations of objective risk that the disease may have an unfavorable evolution.
Paxlovid, Pfizer’s antiviral drug
Throwing a little eye on the future this Pfizer drug appears to have 89% hospitalization prevention capacity and I believe it will be authorized shortly.
The Paxlovid (scientific name) would therefore seem even more effective than the Merck pill. The operation is analog because it would act by counteracting the replication of the virus, even if through a different procedure. These innovative molecules always have a high cost but putting the cost of the drug and that of hospitalization on the scales, I believe that besides all the human aspects, even considering the purely economic aspects, they are much cheaper than hospitalization.
Keep in mind that we do not yet know if this virus can develop resistance to these but if resistances arise we hypothesize to use them together although I am optimistic that resistance will not develop since, contrary to HIV drugs for which resistance often develops, these are only taken for 5 days and the risk in this sense is very low. I am also very well tolerated drugs.
What do you think of the third dose?
Israel is the great laboratory in the world, it was the first to have vaccinated millions and millions of people in a few months, was the first to observe the great laboratory in the world, it is the first that has decided to do a study on over 60s with excellent results with the third dose, and for this reason it extended it to the entire population; I think it rightly influenced the choice of health care bodies in our country. It has been seen that the third dose while it is particularly useful over 40 years in the age group between 16 and 39 there is not a big difference in terms of between those who only do two doses and those who also do the thirdprobably for a clearly different immune system.
Vaccine in children between 5 and 11 years, is it right to do it?
In principle, I would agree but I think we have to wait to understand what the decisions of the international control bodies are on the basis of the dossiers presented by the various pharmaceutical industries. For children there is more of a public health problem because the child itself does not have severe forms; therefore, evidently the administration should not be done because it risks life, though the dead and the grave forms exist, but there may be one prevention of the spread of the virus. we we do not know if this virus can become more aggressive towards children as it continues to circulate. However, it could be that in these children there is a Long Covid even in the presence of non-serious forms of the disease.
Basically I am in favor of vaccination even in this age group because for example in the United States there are 28 million children and 6 million in Italy and it is clear that all these they represent an important vehicle for the spread of the virus.