These drugs can help against the “omicron” variant.
Remdesivir, antibodies, hydroxychloroquine – in the fight against Sars-CoV-2, medicine resorts to many desperate measures. Often with disappointing results. Omicron further complicates the situation. But there are a few who are hopeful
WITHSince the first coronavirus patients in Germany were treated almost two years ago in Munich, the virus has mutated noticeably. The new version of Omicron spread especially quickly. It has been modified in such a way that the vaccinated and the sick are infected more often than the delta variant. In addition, some drugs that have been developed at great expense do not cope with Omicron. But some new drugs offer hope.
According to a study published in the specialized journal Cell, in which German teams from Göttingen, Hannover, Braunschweig and Erlangen participated, some drugs on Omicron seem to lose their effectiveness. According to a statement from the University of Erlangen, this applies to most approved drugs based on antibodies effective against earlier variants.
The body produces antibodies after vaccination or infection. You can join the virus and disable it. Antibodies can also be bioengineered to treat infected people. Since the omicron virus has changed significantly from previous variants, antibodies – endogenous or produced as drugs – can no longer fight the infection as well.
Casirivimab and Imdevimab, Etesevimab and Bamlanivimab: Initially, hope rested on these antibody drugs. If given early, they should prevent severe episodes. The effect is now reduced to Omicron. However, according to research, the new antibody drug Sotrovimab Omicron inhibits. It is also recommended by the World Health Organization (WHO).
Clemens Wendtner, chief infectious disease specialist at the Schwabing Clinic in Munich, who treated the first patients with the coronavirus disease in Germany in 2020, still considers the “toolbox” to be better filled than ever before. The promising drug Sotrovimab should arrive for inpatient therapy at the end of January. “There is also a clear perspective here.”
Although the administration of antibodies helps only in the early stages of the disease, the anti-inflammatory dexamethasone remains the standard treatment in severe cases. Also administered are interleukin-6 antagonists, which also block the inflammatory response and were originally developed for rheumatic diseases, and so-called Janus kinase inhibitors, such as baricitinib. This remedy has also been used for some time to treat Covid-19 and is now also recommended by the WHO. Blood thinners are also administered to prevent thrombosis, strokes, and heart attacks.
Hopes are placed on new antiviral drugs, such as Paxlovid and Molnupiravir – the first pills from Corona, which should appear in pharmacies with a prescription in a few weeks. That makes him optimistic, Wendtner says. “A quantum leap has occurred.”
Pandemic officer at the Klinikum Rechts der Isar of the Technical University of Munich, Christoph Spinner, also sees good opportunities in new drugs. Molnupiravir “is taken as a capsule twice a day for five days and is also effective against the Omicron variant.” Paxlovid will soon be added as an additional oral therapy option. According to Spinner, it also protects against microns – and up to 90 percent against heavy runs.
$700 – for the treatment of one patient
Remdesivir, originally developed against the Ebola virus and approved against the coronavirus in 2020, will continue to be used, Spinner said. “It also works against omicrons and in a new study showed about 80 percent protection against heavy runs.” Unlike oral therapy with Paxlovide and Molnupiravir, Remdesivir must continue to be administered intravenously as a short-term infusion. But it is outpatient.
The federal government has secured supplies of remdesivir for Germany. Now he buys a million units of Paxlovid. The new tablets – Paxlovid and Molnupiravir – are expensive. Five-day treatment costs about 700 dollars. The pills also need to be taken earlier to slow down the virus.
First of all, the antibody drug Evusheld should be used prophylactically, which, according to the manufacturer Astrazeneca, is also effective against Omicron. Unlike previous antibodies, it does not need to be administered through a vein in a hospital, but can be administered once into a muscle. “It works for six months,” Wendtner explains, but cautions that it’s an alternative to vaccination. The drug is much more expensive, but, first of all, it does not stimulate the body to form its own antibodies. It is only suitable for people who do not tolerate vaccination well or cannot form antibodies. Vaccination remains the most effective means, experts emphasize again and again.
The federal government has secured 150,000 doses of the antibody drug Ronapreve (Casirivimab and Imdevimab), for which the Paul Ehrlich Institute at Omikron is also seeing reduced efficacy. At that time, the funds were almost never used. It was nearing its expiration date when it was revived for prophylactic purposes in people who were at particular risk. Now it is clear: “This antibody is a dying model, it will no longer be used on Omikron,” says Wendtner. How many cans are still stored in the cupboards is an open question. Meanwhile, work on new drugs continues under great pressure. For example, the Technical University of Munich (TUM) is researching a spray designed to prevent lung damage from Covid-19.