covid vaccine

COVID-19 treatment update: Here is a list of all drugs used and its implications

Since the first case of coronavirus was detected in China’s Wuhan province six months back, nearly a million people across globe have since lost their lives to the pandemic. Various drugs have been touted as a cure for COVID-19, but to date, there are no specific vaccines or medicines for COVID-19. Treatments are under investigation, and will be tested through clinical trials.

We take a look at the drugs which are being used in for the treatment of COVID-19. None of them is proven treatments; most are still undergoing clinical trials or studies and have been approved for “emergency use” or as an “off-label” drug during the pandemic.

Hydroxychlroquine

Approved as a treatment in mild cases and as prophylactic.

Compelling data from multiple large clinical trials such as WHO’s SOLIDARITY and UK’s RECOVERY trials show HCQS does not show benefits in treatment.

Studies on prophylaxis benefit ongoing and have shown some benefit, however, it is not yet conclusive.

USFDA revoked Emergency Use Authorisation, India moved the drug out of treatment protocol for severe cases.

Side-effects: Severe heart arrhythmia.

Favipiravir

An oral antiviral drug, fast-tracked by Drug Controller General of India Received Emergency Use Authorisation for treatment of mild or moderate infections.

The drug not approved in the EU or US.

Approval based on Glenmark’s clinical trial of 150 mild to moderate patients. Early data showed reduction in fever. Trials completed and results are awaited.

Additional clinical trial data of 80 patients in China showed a decrease in viral load.

Contraindications: Cannot be given to patients with severe renal complications, hepatic impairment, pregnant and lactating women.

Glenmark sells brand Fabiflu, at Rs75 / tablet, reduced from Rs 103 earlier. The company has also started a post-marketing surveillance study of 1000 patients.

Dr Reddys Labs expected to launch in partnership with Japan’s originator co Fujifilm.

More players are expected to enter the fray.

Remdesivir

Gilead Sciences’ patented anti-viral drug, earlier tried on Ebola.

Hospital-only, Injectible drug.

Has Emergency Use Authorisation for treatment of moderate to severe COVID-19 patients.

Well-designed clinical trials show Remdesivir to be effective, shown to shorten recovery time & hospital stay but does not reduce mortality.

Clinical trials currently underway to prove efficacy.

As prescriptions go up and drug manufacturing is limited, the drug is seeing massive shortage across the country.

 

Tocilizumab

Hospital-only, Injectible drug originally used in patients with rheumatoid arthritis.

Approved as an “Off-label” drug for the treatment of moderate to severe COVID-19 patients.

Works to counter the severe inflammation (cytokine storm) that occurs in some Covid-19 patients.

Clinical trials have shown reduced immune inflammation. Tocilizumab works when the immune response is already inflamed and helps to arrest the impending cytokine storm, which affects other organ functions.

 Manufactured by Roche Pharma, marketed by Cipla under brand name Actemra.

Adverse events cited – Can increase the risk of bacterial infections.

Itolizumab (only preliminary results available)
  • Biocon’s Hospital-only, Injectible drug earlier approved for the treatment of Psoriasis.

    Has got Emergency Use Authorisation for treatment of moderate to severe COVID-19 patients.

    Approval based on 30 patients’ clinical trial where 20 patients were out on Itolizumab, 10 randomised on standard care.

    All 20 on Itolizumab survived, 3 out of 10 on standard care died during the trial Itolizumab works in handling the hyperactivity of the immune system and managing cytokine storm.

    Itolizumab works best when given to patients on non-invasive ventilator support — before the immune response is hyperactivated and works to delay or slow down cytokine storm.

    Another small study in Cuba on 76 invasive ventilated patients showed – 79.2 percent severely ill patients discharged from ICU after 14 days.

     Itolizumab & Tocilizumab both work on controlling hyperactive immune response and cytokine storm but differ in the timing.

    Steroids: Dexamethasone

    The only drug so far to show striking impact on mortality.

    Clinical trial ongoing – UK’s RECOVERZY Trials showed Dexamethasone can reduce deaths by one-third in patients with severe Covid-19 infection who need oxygen therapy or are on ventilators.

    The old, inexpensive drug, Approved as “off-label” drug for COVID-19 severe cases Works to control immune response and cytokine storm triggered by Sars-Cov2.

    Doctors say Dexamethasone works only for late-stage, invasively ventilated patients. Must not be given in mild cases.Other drugs part of Ministry of Health Clinical Management protocol.

     Methylprednisolone

    For use as an anti-inflammatory drug.

    Low molecular weight Heparin

    To prevent blood clots & thrombogenic response.

     Antibiotics – Azithromycin, Ivermectin

    To deal with infections.

    Convalescent Plasma Therapy

    Approved as an “off-label” therapy and works best when given early on in the treatment cycle.

  • COVID-19, SAR-CoV- treatment medicines:  Remdesivir, Hydroxychloroquine, Chloroquine, Lopinavir, Umifenovir, Favipiravir, Oseltamivir, Azithromycin, Vitamin C, Methylprednisolone, Epoprostenol, Nitric oxide, Sirolimus, Sarilumab, Tocilizumab, Anakinra, Convalescent plasma, Traditional Chinese Medicine

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