Coronavirus drugs are coming. Experts test drugs against cancer or Ebola for their effects against Sars-CoV-2. Your advantage: they could be used soon. Because they are already approved.

It is not until 2021, experts agree, that there will be a vaccine against Covid-19. However, another smaller class of active ingredient may be available within a few weeks – and lessen the severity of the disease.

Many companies and research groups are currently looking for such coronavirus antivirals. They focus on already approved preparations. They’ve already completed the very long and costly walk through the clinical trials that each new drug has to go through to make sure the risks and side effects are limited.

These drugs could be available much faster than a vaccine – and possibly save lives. Because even if antiviral drugs are not as effective as drugs against bacteria, they can significantly weaken a serious and imminent course of the disease. Already at the start of the pandemic, doctors in China and other countries tried to help seriously ill patients by using drugs that act against other viruses if they are suspected.

Coronavirus drugs are coming

Meanwhile, a real campaign has been launched on the HIV drug Kaletra in China, when Thai doctors reported their success with the drug. Certain studies in progress are now supposed to verify it scientifically. However, the preparation works specifically against the HIV protease, which helps the virus to assemble its viral envelope and other parts. The enzyme is specific for the HI virus, which is why it is not clear whether the combination of drugs actually acts significantly against the corresponding enzyme in Sars-CoV-2.
Prototype: Sars
Coronavirus drugs are coming. Experts test drugs against cancer or Ebola for their effects against Sars-CoV-2. Your advantage: they could be used soon. Because they are already approved.

Coronavirus drugs

 

However, the working groups are now using the now known properties of the virus to systematically search for promising candidates among existing drugs. Because similar to conventional antibiotics, antiviral drugs work against different metabolic pathways, which can be common to more than one virus. Above all, experts rely on experience with the 2003 Sars corona virus, which is very close to the current virus.

“The two viruses use very similar strategies to penetrate cells and can also trigger the disease via similar mechanisms,” says infection biologist Markus Hoffmann of the German Primate Center in Göttingen (DPZ), who explains the exact processes involved in penetration of Sars-CoV 2 research into lung cells. Both viruses use the same cell receptor to connect to their target cells. “So current knowledge of Sars can help fight Covid-19.”

Hoffmann and Stefan Pöhlmann, head of the infectious biology department at DPZ, study how the virus reaches the victim. “Research into how Sars-CoV-2 enters lung cells can identify targets for therapy,” says Pöhlmann. Scientists discovered in late January that a crucial step in this process was sensitive to a known drug.

Coronavirus drugs are coming
Coronavirus drugs are coming

In February, Bruce Aylward of the World Health Organization said that remdesivir is currently the only active ingredient the organization believes to have an effect. This assessment seems to be based on several results from recent years, according to which the active ingredient in animal models acts not only against Sars, but also against the Sea, which is also triggered by a coronavirus.

Coronavirus drugs are coming. Experts test drugs against cancer or Ebola for their effects against Sars-CoV-2. Your advantage: they could be used soon. Because they are already approved.

Coronavirus drugs

 

Remdesivir also has a very wide range of applications due to its mechanism of action – each RNA polymerase must bind the building blocks of the RNA and therefore also their imitations. Another active ingredient in this group is ribavirin, it also inhibits RNA polymerase from various RNA viruses and has also been tested against Sars. And more than one drug will be needed to effectively treat Covid-19. Experience shows that a single active ingredient creates resistance to the virus in a relatively short time. Even if Remdesivir proved to be very effective, the research would not stop there.

Inappropriate flu medications

A completely different class of active ingredient is to be tested in China in several large clinical trials on patients. The active ingredient umifenovir, like the camostat, prevents the virus from entering the cell – however, it interferes with the stage after the pathogen has been anchored to the cell, when the membranes of the two must merge to release genetic material. virus in the cell. The active ingredient is approved in Russia and China for influenza.

The drug chloroquine, which is approved for malaria and rheumatism, works by a similar mechanism. It has given encouraging results in experiments with cells and supposedly also in clinical use. It is currently clinically tested in several studies.

A number of other influenza medications are also in the pipeline, including neuraminidase inhibitors such as the active ingredient oseltamivir, which disrupt the virus as millions of new viruses begin to emerge from the cell. It is not clear if these substances work – in tests on Sars, they did not work too well.
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Coronavirus drugs are coming

In fact, the field of clinical trials on potential drugs has become confusing. Because in addition to these active ingredients and others already approved, the pharmaceutical companies are already working on new specific drugs, in the hope that the generalized epidemic will not disappear soon.

Not only the classic active substances in the race, some of which were already promising when Sars appeared – for example helicase inhibitors, which interfere with another specific step in the treatment of the viral genome. They are joined by drugs based on antibodies; a strategy that fights viruses just like vaccination.

However, these new developments also have a common problem with vaccination: the long development time, mainly due to extensive clinical studies. And while a promising vaccine would likely be rushed into all approvals – experts expect such a vaccine as early as the summer of 2021 – a drug would be less likely to benefit from such special treatment. After all, that does not solve the fundamental problem of the rapid spread of the virus.

Welcome would be an effective remedy for the virus anyway. On its own, this would significantly reduce the impact of major outbreaks on the health system, not to mention relief for patients. The first studies on remdesivir and other active substances are expected to be completed in early April. Experts are confident that the first drugs will soon be available. For example, Lothar Wieler, president of the Robert Koch Institute, said: “We are optimistic that these drugs will also be used in Germany in the coming weeks”.

Autor : Lars Fischer