Two drugs for the treatment of COVID-19 approved in the United States: how they work

The United States has officially approved two drugs for the treatment of COVID-19: paxlovid and molnupiravir. Let's see what these drugs are and how they work.

Paxlovid

Paxlovid works on the basis of two active ingredients: protease inhibitors and the antiretroviral ritonavir. Snob. Protease inhibitors inhibit an enzyme that breaks down bonds between amino acids in proteins. The antiretroviral ritonavir is used in the treatment of HIV and AIDS. It was added to Paxlovid to maintain a high concentration of inhibitors in the blood for as long as possible. The instructions for the drug say that it actively resists various variants of the coronavirus, including delta, gamma and mu.

When a person becomes infected with COVID-19, two proteins begin to be synthesized in their body - they are the ones that help the virus multiply. Among the functional fragments of these proteins is RNA polymerase, which duplicates the viral genome. Merck's molnupiravir, which has been successfully tested ended a month ago, blocks it. Paxlovid blocks the protease. When blocked, the proteins that multiply the cells of the virus are not activated.

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Pakslvid Developers insistthat pills are not a substitute for a vaccine and that you need to take a test for COVID-19 immediately after the first symptoms appear, only then Paxlovid will bring maximum benefit.

Paxlovid research

Paxlovid was tested in a placebo-controlled manner. The patients were randomly divided into two groups. The doctors gave the first group a medicine for five days every 12 hours, the second - a placebo.

Only unvaccinated people who became infected no earlier than five days before the start of the trial could take part in the study. Participants had one or more risk factors:

• age 60+
• diabetes
• obesity
• smoker status
• chronic kidney disease
• chronic lung disease
• oncological disease in the active phase

There were two variants of the study: in one - Patients started taking pills on the third day after the first symptoms of the disease, in the second - on the fifth.

Initially, the developers planned to test Paxlovid on three thousand people, but already in the middle of the study, an independent group of scientists came to the conclusion that the data collected was enough to stop the trials ahead of schedule and start registering the drug.

Without waiting for FDA (Food and Drug Administration) approval, the company invested $1 billion in pill production.

Efficacy and safety

Among those who started taking the drug three days after infection, three people out of 389 (0,8%) were hospitalized - all of them remained alive. Of the 385 placebo patients, 27 (7%) were hospitalized - seven of them died. The risk of hospitalization with early use of Paxlovid is reduced by approximately 89%.

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In the group that began taking the drug on the fifth day, six patients out of 607 (1%) were hospitalized - there were no deaths. Of the 612 people who took placebo, 41 (6,7%) were hospitalized - ten of them died. The effectiveness of the drug with a relatively late start of treatment is 85,2%.

In the short term, the drug does not have any serious side effects. Minor (what exactly, is not specified) - were in 19% of patients taking Paxlovid, and in 21% of those taking placebo.

How much will paxlovid cost

In high-income countries, the price of Paxlovid will be $700 for a five-day course, about this сообщил Pfizer CEO Albert Burla. For low-income countries, the price will be such that there are no “barriers to access to the medicine”.

By the end of the year, Pfizer plans to produce more than 180 doses of the drug. In 2022, the company plans to release up to 50 million doses.

Molnupiravir

Molnupiravir is an antiviral drug developed by Merck. It prevents moderate, severe and fatal COVID-19 disease, report News. According to the instructions, the medicine should be taken twice a day for five days. The course should begin on the fifth day after the onset of symptoms.

Molnupiravir research

The third stage of clinical trials involved 775 patients. The study included patients with mild to moderate COVID-19 who had symptoms for five days. Participants were required to receive vaccine and belong to high-risk groups, i.e. the elderly, those with diabetes, obesity or cardiovascular disease.

Merck essentially interferes with the genetic code of the virus, pregnant women did not participate in its tests - the developers talked about the potential risks of birth defects. Paxlovid, which works on a different principle, did not have such restrictions.

Studies have shown that medications halve hospitalizations or deaths from COVID-19. The results of 775 participants are as follows:

• 7,3% of patients were hospitalized (but among those who took placebo, this turned out to be 14,1%)
• there were no deaths among people taking molnupiravir
• two placebo patients died.