Many different drug products have been developed to fight COVID-19. mRNA vaccines such as those produced by Pfizer-BioNTech and Moderna have been distributed worldwide to prevent the spread of the disease. Johnson & Johnson, AstraZeneca, and other companies have also developed vaccines for widespread distribution. While vaccination is important for preventing the disease, antiviral medications may be necessary to treat the virus in people after an infection has already occurred. So far, Gilead Sciences’ remdesivir is the only FDA-approved antiviral drug that is administered intravenously (injected into a vein) to hospitalized patients to treat COVID-19. Although remdesivir can be used to treat more severely ill patients, a COVID-19 antiviral drug for early widespread use to treat less severely ill patients has not yet been approved.
Pharmaceutical company Merck & Co. and biotechnology company Ridgeback Biotherapeutics have been developing an antiviral drug called molnupiravir that can be packaged as pills and taken orally to treat COVID-19. The drug interferes with the working process of the SARS-CoV-2 polymerase—the enzyme that replicates the COVID-19 virus within the body. Molnupiravir introduces errors into the genetic code of the SARS-CoV-2 virus so that when the virus copies itself, the viral copies are weak and dysfunctional. When so many mistakes are put into the viral genetic material, the virus eventually no longer reproduces and infection halts.
Adding mutations into the viral genes encoding for coronavirus will eventually stop it from replicating within the body.
Molnupiravir is designed to be taken twice daily for five days and Phase 2 trials have shown beneficial results in treating people who experience infection from COVID-19 early on. Within just a week, many patients experienced fewer symptoms, and within two weeks, they had fully recovered. For patients who were already hospitalized, however, the pill provided no benefit. Merck and Ridgeback announced in early September that they now plan to enroll uninfected people who live with a person who has COVID-19 in a new Phase 3 trial to test the drug’s ability to prevent infection. The companies hope for positive results in order to obtain FDA approval, allowing for widespread, accessible distribution of the antiviral product not just within the U.S., but also to low-and-middle-income countries.
Antivirals in the form of pills take a large burden off of hospitals. Oral antivirals are already essential treatment methods for other viral infections such as hepatitis C and HIV. A widely prescribed pill known as Tamiflu shortens the duration of influenza and reduces the risk of hospitalization. Doctors are able to prescribe the oral medication to a person’s pharmacy where they can quickly have it delivered or picked up and then taken in an easily digestible form. With the potential treatment effects of molnupiravir, people infected with COVID-19 may not have to risk becoming seriously ill before getting treatment in the hospital— they can fight it early on.
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