As the world grapples with the rapid spread of the new strain of coronavirus (2019-nCoV), the medical and scientific fraternity is working laboriously to find viable ways to treat the thousands of people affected by it.
Efforts to develop a vaccine are ongoing, but a new vaccine will probably take months, or even years to come into actual use — as our past experiences with Ebola or Zika have shown.
The first Ebola vaccine, for instance, emerged after almost 20 years of research and four years of clinical testing, while for Zika or SARS (2003), tests are still underway.
As the death toll from the Wuhan coronavirus increases sporadically, parallel efforts are on to look for interim, or hopefully permanent solutions for faster improvement in patients. In a few cases across the world, antiviral drugs have seemed to work.
‘Cocktail’ of Drugs Used to Treat Patients
The Drug Controller General of India (DCGI) has consented to the ‘restricted use’ of a combination of anti-HIV drugs for treating those affected by 2019-nCoV, after the Indian Council of Medical Research had sought an emergency approval for the use of the two drugs — ‘lopinavir’ and ‘ritonavir’.
According to a Reuters report, doctors from Rajavithi Hospital in Bangkok have successfully treated severe cases of the virus using a combination of drugs for flu and HIV. In fact, a 70-year-old Chinese woman from Wuhan, who had tested positive initially, showed improvement within two days. Dr. Kriangska Atipornwanich, a lung specialist at Rajavithi, told reporters,
The combination includes a mixture of anti-HIV drugs lopinavir and ritonavir, along with the flu drug oseltamivir in large doses.
Even Chinese health authorities have been administering these drugs, while maintaining that there is no effective cure for the virus yet.
Another antiviral drug, called remdesivir, which had initially been developed to fight Ebola, was used to treat the first patient affected by the Wuhan coronavirus in the US. The Wuhan Institute of Virology has applied for a patent in China for the use of this antiviral therapy, IANS reports.
The Indian pharmaceutical major Cipla, is reportedly keeping a stock of the two anti-HIV drugs ready to deal with the virus. Chairman Yusuf Khwaja Hamied said that these medicines are off-patent and are now being repurposed. “We are not approaching the Indian government that in case of any emergency, we will rise to the occasion and help,” a Business Today report quotes him as saying.
However, in all the cases where improvement was seen in patients, researchers have asserted the need to hold randomized control studies to be sure of the safety and efficacy of these medicines.
In fact, one of the patients in Thailand showed an allergic reaction to the drug cocktail, raising doubts for any universal application.
Indian Experts Weigh In: Are These Drugs Reliable?
FIT spoke to Dr Naga Suresh Veerapu, a virologist and assistant professor at Shiv Nadar University, who said that it is difficult to believe that antiviral drugs could be effective in all cases. SARS was a similar strain, and there is no treatment modality for it yet.
However, until a vaccine is developed, which could take at least a year, testing antivirals could be a quicker alternative, he adds.
Highlighting the need for a clinical trial, Dr Samit Bhattacharyya, head of the Disease Modeling Laboratory at Shiv Nadar University, said, “So far, we have only seen a few cases where antivirals worked. Those could be patient-specific. Unless there is a proper trial, we can’t make any statements.”
When asked about the current methods of treatment being used on patients affected by the novel coronavirus, both experts agree that there is no clarity yet. Doctors around the world are trying all sorts of treatment combinations. They could be choosing among antiviral options available in the repository to see what works. “There must be a trial and error approach. The current combination of drugs working on a few patients is not surprising,” Dr Veerapu said.
Dr Bhattacharyya also raises an important question.
But how does this explain the DCGI approval for the ‘restricted use’ of these drugs?
Dr Veerapu says that the idea behind approving these drugs is that they have already been tested for previous illnesses. So we know they are safe, and if they work against the new strain, it would be great. ‘Repurposing’ the drugs, as this is called, could be the fastest possible solution to the epidemic.
The only way forward, therefore, is clinical testing of these drugs. Efforts in this direction are already underway, with China testing an HIV medicine called Aluvia as a treatment option, reports suggest.
(This story was auto-published from a syndicated feed. No part of the story has been edited by The Quint.)
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