Health & Beauty

Recently, progress has been made in the research and development of many new crown oral drugs around the world, bringing new hope to the fight against the epidemic. Experts pointed out that vaccines and drugs are complementary "combined punches", and prevention and control measures, vaccines and therapeutic drugs are indispensable for a successful fight against the epidemic in the future.

u3000u3000 Progress in a variety of oral drugs

On the 4th of this month, the world's first oral anti-coronavirus drug, Monabilav, jointly developed by Merck and Richbuck Biomedical Company of the United States, was first approved by the Medicines and Health Products Administration of the United Kingdom for the treatment of certain patients with COVID-19 . According to the interim analysis data of the Phase III clinical trial released by Merck on October 1, the drug can reduce the hospitalization/death risk of patients with mild and moderate new crowns by about 50%. Show consistent efficacy.

u3000u3000 Monabilavir is actually an "old drug with new use". Its research and development can be traced back to 2014, and it was discovered when screening anti-Venezuelan equine encephalitis virus drugs. Liu Shuwen, vice president of China Southern Medical University and chairman of the Guangdong Provincial Pharmacological Association, introduced that the new coronavirus is an RNA (ribonucleic acid) virus, and monabiravir can "adulterate" the new coronavirus genome and induce it to produce false mutations. To disrupt genome replication, thereby inhibiting the spread of the virus.

u3000u3000 Following the approval of monabiravir, Pfizer announced the latest data on a more effective oral antiviral drug PAXLOVID. The results of the interim analysis of phase Ⅱ/Ⅲ clinical trials showed that oral administration of the drug can reduce the risk of hospitalization and death by 89%. The drug is composed of the small molecule drug PF-07321332 and ritonavir. The former is an inhibitor of the main protease of the new coronavirus, and ritonavir is an antiviral synergist, which has previously been used against HIV.

u3000u3000 Another "old medicine and new use" oral medicine is also attracting attention. The British "Lancet Global Health" published a research report from Brazil on October 25, stating that fluvoxamine, a commonly used antidepressant, can significantly reduce the risk of severe illness/death in patients with COVID-19. In the early stage of the new crown, the risk of death after taking the drug can be reduced by about 90%, and the risk of severe hospitalization can be reduced by about 65%. The British "Nature" magazine reported that fluvoxamine can suppress the immune response and relieve tissue damage, and the inflammatory factor storm caused by the overreaction of the immune system is an important factor in the severe illness and death of the new crown.

u3000u3000How to see advantages and risks

Ding Sheng, director of the Global Health Drug Research and Development Center and dean of the School of Pharmacy of Tsinghua University, told reporters that in terms of large-scale promotion, small-molecule oral drugs have more advantages: convenient for early medication; low synthesis cost, can be stored at room temperature, and easy to purchase and use in developing countries ; It can be quickly used in high-risk groups such as close contacts to help mild patients quickly control their condition.

Vikas Sucateme of Emory University School of Medicine believes that fluvoxamine treatment of new crown is a major victory of "old medicine and new use", which can be used for not being vaccinated or unable to receive monoclonal antibody treatment, and the risk of disease deterioration Higher patients. Another advantage of fluvoxamine is its low price. A 10-day course of treatment costs only US$4. The patent for the drug has expired and is convenient for production. Once approved, it will benefit many underdeveloped countries and regions in terms of accessibility.

u3000u3000 Several new crown oral drugs have outstanding advantages, but their risks are also worthy of attention. First of all, the phase III clinical trials of these drugs are not large, and the data disclosure is limited. It is necessary to observe the safety and effect through long-term and large-scale use.

u3000u3000 Among them, the mechanism of action of monabiravir is to destroy the RNA replication of the new coronavirus. Scientists are worried that it may affect the human body's DNA (deoxyribonucleic acid) or RNA. Liu Shuwen said that monabiravir, as a nucleoside analog that "induces mutations", may cause gene mutations in normal cells of the body, and it does not rule out the risk of cancer-causing mutations.

u3000u3000Secondly, the new coronavirus may also produce drug-specific mutations, which may lead to drug resistance. In response to the problem of drug resistance, Liu Shanlu, a professor of virology at Ohio State University in the United States, said that the solution is combination medication, which is "cocktail therapy."

u3000u3000 Anti-epidemic still needs "combined boxing"

u3000u3000 There is a view that there is no need to vaccinate the new crown oral medicine. Many experts pointed out that this is a dangerous misunderstanding. Whether it is to prevent infection or reduce the rate of severe illness and mortality, the role of vaccines cannot be replaced. When the British government website announced the approval of monabiravir, it specifically pointed out that it cannot be used as a "substitute" for the new crown vaccine.

u3000u3000 "Therapeutic drugs and vaccines are not conflicting and antagonistic, but complementary." Ding Sheng said.

Chen Ling, a distinguished researcher at the Guangzhou Institute of Biomedicine and Health, Chinese Academy of Sciences, pointed out that vaccines and drugs are complementary "combined punches": vaccines are not vaccinable for everyone, and their protective effects and durability are not yet fully understood; Poor people are not well vaccinated, and drugs can protect these people. With vaccine protection, fewer people will eventually need drugs. Even if the drugs have certain side effects, the absolute number will not be very large from a percentage point of view. With the development of more effective and durable vaccines, the use of drugs will be reduced even more.

u3000u3000 The epidemic is far from over. A good fight against the epidemic in the future is inseparable from prevention and control measures, vaccines and therapeutic drugs. Wang Liming, a professor at Zhejiang University's Institute of Life Sciences, said that the new crown treatment drugs plus effective vaccines are undoubtedly of great value for formulating and revising public policies for the prevention and control of new crowns.

u3000u3000Chen Ling also believes that in the long run, the emergence of oral drugs has indeed injected a "cardiotonic" into the world. "With the cooperation of drugs, the pace of world opening up and economic recovery will also accelerate."