The era of anti-Covid pills is on

A pill or a tablet to cure Covid? US giants Merck (MSD) and Pfizer announce very encouraging results for oral treatments, while an antidepressant is also showing promising signs, perhaps opening a new chapter in the fight against the pandemic.

What are these treatments?

We are talking about oral treatments, pills or tablets, which would be given at the first symptoms of Covid-19 in order to avoid serious forms and, therefore, hospitalizations. After months of research, two American pharmaceutical giants have just announced that they had succeeded: Merck, in early October, with its molnupiravir, and Pfizer, this Friday, with its paxlovid. They are antivirals, which work by reducing a virus’s ability to replicate, thereby slowing down the disease.

Both groups point to a sharp reduction in hospitalizations among patients who took their treatments: by half for molnupiravir and almost 90% for paxlovid, although it is necessary to be careful not to compare these efficacy rates directly because of different protocols depending on the studies. At the same time, an antidepressant already in the public domain, fluvoxamine, has shown encouraging results in preventing severe forms of Covid-19, according to a study published in October by Brazilian researchers in the Lancet Global Health.

Why is this important?

If the effectiveness of these drugs is confirmed, it will be a major step forward in the fight against Covid-19. They would come in addition to vaccination – and not replace it – to complete the therapeutic arsenal against the virus. Of course, treatments already exist, mainly in the form of synthetic antibodies. But these drugs, which are generally aimed at patients already suffering from severe forms, are injected intravenously and are therefore complex to give.

In contrast, a pill or tablet can be quickly prescribed to a patient who will then easily take it at home. The treatments of Merck and Pfizer, which also evoke few side effects, provide about ten intakes in five days. “The success of these antivirals potentially opens a new era in our ability to prevent serious consequences of infection with SARS-Cov2”, welcomed the British virologist Stephen Griffin, in a reaction given to the Science Media Center.

What limits?

It remains difficult to assess precisely the precise interest of Merck and Pfizer treatments, because the two groups have so far only published press releases, without making available the details of their clinical trials. However, we must “take with caution” this type of announcement while waiting to be able to read the studies, recalled in September the French infectious disease specialist Karine Lacombe, stressing that such treatments represent a “potentially huge” market for manufacturers.

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However, certain elements clearly indicate that Merck and Pfizer are not making empty promises, firstly the fact that, with the approval of independent monitoring committees, they halted their trials earlier than expected in the face of results. very conclusive.

As for fluvoxamine, if the study is accessible to all, it is not without criticisms. Several researchers regret that the authors did not only assess the frequency of hospitalizations but also those of extended stays in the emergency room, thus complicating the interpretation of the data.

For when ? And for how much?

Merck’s molnupiravir has already been approved in the United Kingdom, where health authorities on Thursday approved its use in patients with at least one risk factor for developing a serious form: the elderly, obese, diabetics … The authorities health officials in the United States and the European Union (EU) are also urgently reviewing the drug. The European Medicines Authority (EMA) thus promised Thursday to “accelerate” even if it is careful not to give a date.

Several countries have already ordered stocks of monulpiravir, such as France – 50,000 doses – and especially the United States which has ordered a stock to ensure 1.7 million treatments. The American order gives, in passing, an idea of ​​the high price of this drug. It represents $ 1.2 billion, or some $ 700 per treatment. As for Pfizer, which for the moment only refers to an authorization request in the United States, it has not detailed the price of paxlovid, promising that it would be “affordable” and differentiated according to the countries and their level of development. .

A pill or a tablet to cure Covid? US giants Merck (MSD) and Pfizer report very encouraging results for oral treatments, while an antidepressant is also showing promising signs, possibly opening a new chapter in the fight against the pandemic. We are talking about oral treatments, pills or tablets, …

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