COVID-19 will be treated differently

Medicines

12.02.2022

Against the background of the already habitually bleak reports about the ever-spreading omicron, more positive information about a new covid infection drug in Russia, molnupiravir, has appeared.

Marina ANIKEEVA

Perhaps with his help it will be possible to stop the pandemic and significantly reduce the flow of citizens in need of hospitalization. Time will show.

The drug based on an internationally recognized molecule was developed and put into production by Promomed Group of Companies. The drug containing molnupiravir (Esperavir) was created in Russia using innovative technology, taking into account international experience and recommendations of international COVID-19 treatment protocols, and recently received a registration certificate as a result of successful clinical trials on thousands of patients worldwide.

This is another anti-covid drug (we have already written about Areplivir, created by the same Promomed company) for doctors and their patients who do not want to go to a hospital bed with complications. It can be used at home as prescribed by the attending physician at an early start of treatment for COVID-19 or at the first signs of acute respiratory viral infections — this allows you to make a convenient form of release in the form of capsules.

As the developers explain, for the first time during the pandemic, doctors have the opportunity to choose how to fight covid — favipiravir or molnupiravir. Both molecules act directly and precisely on the virus, very quickly suppressing its reproduction in the body and, as a result, preventing organ damage even in the asymptomatic phase. It has been proven that in the fight against covid, it is the speed of virus destruction that plays almost the most important role, reducing the risks of a complicated course of the disease and preventing the development of negative consequences. Depending on the patient's condition and the presence or absence of chronic diseases, the doctor will be able to choose the most appropriate therapy for this particular person.

"...The virus leaves doctors almost no room for error. The merit of Russian scientists and developers is that the line of anti—covid drugs is now available to the national health service. The first of them, favipiravir, has a decent evidence base and extensive use experience, its effectiveness has been studied in hundreds of thousands of patients across the country; the second, molnupiravir, has just arrived in the country, but drugs based on this molecule are well studied. There are about ten clinical trials conducted in different countries, including the Promomed group in Russia, which you can safely rely on in your medical practice," commented Sergey Avdeev, Chief pulmonologist at the Ministry of Health of the Russian Federation, Corresponding Member of the Russian Academy of Sciences.

At the moment, the novelty has passed all the necessary clinical trials and has been studied in sixteen Russian medical institutions in Moscow, Saransk, Yaroslavl, Smolensk, Ryazan, Kirov, St. Petersburg, Ivanov, Voronezh, etc. Of course, due to ignorance, most of us still have questions: is the drug harmful, is it dangerous to use it in the long term? It would be appropriate to recall here that the active substance itself has been known to science for several years, and clinical trials have shown a very good safety profile. That is, we can rely on the data obtained from the research results and on authoritative opinions.

Straight to the point

—Promomed's activities comply with the principles of so–called translational medicine," Andrei Budnevsky, MD, Professor, Vice-Rector for Scientific and Innovative Activities, Head of the Department of Scientific and Innovative Activities, Head of the Department of Faculty Therapy at Voronezh State Medical University named after N. N. Burdenko, presents his vision of the situation. — This area of medicine involves the accumulation and transfer of all the achievements of world science and all research into practical healthcare. We can say that this is a modern trend. The fact is that it often takes a very long time from the discovery process to the introduction of a useful technology into mass use. For example, on average, it takes about 10 to 15 years to develop a single drug. The pace of the spread of coronavirus infection does not leave humanity with so much time. This means that it needs to be reduced and the best practices that are available should be used for the fastest and most effective development and application of new therapeutic and diagnostic approaches in the clinic. Internationally recognized drugs have a high reputation, in particular, molnupiravir (it has existed since the early 2000s, and now it comes out with a Russian name). Taking the drug can lead to a reduction in the risk of hospitalization, complications of coronavirus infection and the number of adverse outcomes. Clinical studies have proven the advantages of this therapy compared to the standard one. How does it work? By "embedding" into virus particles, the drug suppresses its replication, that is, reproduction in the body. And already on the 5th day of the course of the disease, more than 80% of patients have complete elimination of the virus (elimination from the body).

Will we breathe more freely soon?

Everyone is waiting for the pandemic to come to naught. But, alas, there are not so many objective prerequisites for this yet. The growing numbers of newly infected people rather indicate the opposite. The pace of vaccination in countries around the world, including Russia, leaves much to be desired. There is no trust in vaccination in society. Therefore, it remains to hope for the invention of a "magic" pill against covid-19. And, I must say, we have good reason to place great hopes on our researchers and scientists. It is possible that antiviral drugs are destined to put a winning point in this protracted war of mankind with the virus.

"Another drug for the treatment of coronavirus infection has entered the market," comments Elena Simakina, head of the Infectious Diseases Department at the Smolensk Clinical Hospital, doctor of the highest category, assistant professor at the Department of Infectious Diseases at SSMU. —It has shown activity against many strains of RNA viruses in the lowest concentrations: influenza, avian influenza, viral encephalitis, a number of "cold" viruses and, most importantly, against COVID-19. That is, there is a wide scope for the use of this drug in various acute respiratory viral infections accompanied by catarrhal syndrome. What else is important to emphasize: the product has a high safety index. In addition, the wider the range of drugs, the better and safer it is for both patients and doctors. For some, one medicine will work, for others, another will help more. Each of these products will occupy its own niche. The new drug is indicated for almost everyone. The full course of therapy is 5 days. But we will not immediately discount the existing antiviral drugs that we have used before. However, it is already clear at the moment: We have received a breakthrough drug that is sure to be in demand in outpatient therapy. Already on the third or fourth day after the start of its use, the viral load decreases significantly, the signs of intoxication of the body (fever, body aches, headache, etc.) disappear, the risk of damage decreases (primarily in the lungs), patients feel better, and progressive recovery begins.

A difficult but solvable problem

"It is well known that the treatment of COVID-19 is a rather difficult problem, because effective drugs against this virus did not exist before," says Vladimir Chulanov, chief freelance specialist in infectious Diseases at the Ministry of Health of the Russian Federation, Deputy Director for Research and Innovative Development at the National Medical Research Center for Phthisiopulmonology and Infectious Diseases. — When the epidemic began, pharmaceutical companies – both foreign and domestic — began to actively engage in the search for and development of drugs for the treatment of COVID-19. And first came favipiravir. Relatively early, back in 2020, it was investigated for effectiveness and included in Russian recommendations, and is currently being successfully used.

It is clear that the effectiveness of existing drugs is limited, so this train does not stop, it goes forward, and many companies continue their search and create drugs that turn out to be even more effective.

One of these new drugs is molnupiravir, which, like favipiravir, inhibits one of the key enzymes of the virus. This is the enzyme that is involved in the reproduction of the virus. But the mechanism of action of the new drug differs from that of favipiravir. And it is especially indicated in the first five days of the disease and is applicable at home. It is important that there are different means to combat the virus, which is spreading at a high rate. New medicines can be successfully used to treat omicron and other well-known strains of coronavirus infection.