💊😷💉 Treatment combinations show 'good activity' against delta variant 💊😷💉

[Stimulus mind]

As the COVID-19 delta variant continues to spread around the country and occasionally breakthrough vaccines, doctors continue the search for drugs and therapies to limit hospitalizations and lower the death rate of COVID patients. Last month, the federal government poured $3 billion into a new program to develop antiviral drugs to treat COVID-19, called the Antiviral Program for Pandemics, with the goal of making pills that can be taken at home as soon as symptoms develop.

Other projects to find more treatments include Recovery in the United Kingdom, the world’s largest clinical trial; the World Health Organization’s Solidarity trial; the University of Oxford’s Principle trial searching for medicines to help recovery at home; and numerous pharmaceutical companies running trials of their own.


The federal government has also been partnering with private companies to run clinical trials in the Accelerating COVID-19 Therapeutic Interventions and Vaccines program. In addition, STOP-COVID is an independent collaborative network to study treatments, made up of more than 400 unpaid volunteer research coordinators, nurses, residents, medical students and physicians.

However, experts are saying treatment is putting the cart before the horse.

FILE - In this July 22, 2021 file photo, a health care worker fills a syringe with the Pfizer COVID-19 vaccine at the American Museum of Natural History in New York. (AP Photo/Mary Altaffer)

As opposed to the record-breaking pace that the vaccine was developed, successful treatments have proven to be more difficult to create. This holds true historically — according to Dr. Stuart Campbell Ray, vice-chair of medicine for data integrity and analytics and professor of medicine at Johns Hopkins University School of Medicine.

He pointed out that effective treatment for tuberculosis took 100 years, for syphilis half a century, and the same story goes for HIV AIDS, gonorrhea, malaria and more.

Dr. Anthony Fauci, head of the National Institute of Allergies and Infectious Diseases, said in March of this year that the government should take the same strategy with SARS-CoV-2 antivirals as it did with HIV antiviral drugs — transforming the virus into a treatable condition.

COVID treatments have improved over the past year, but largely on a trial-and-error basis.

Very early in the pandemic, we really didn’t know what might work. We had no good evidence and we had no good therapies,” Ray said.

FILE - In this Jan. 28, 2021, file photo, doses of the Moderna COVID-19 vaccine sit in a tray of a pharmacy station at the Hamilton County Health Department's new COVID-19 Vaccination POD at the CARTA Bus Terminal in Chattanooga, Tenn. (Troy Stolt/Chattanooga Times Free Press via AP, File)


Four categories designate potential treatments, and each needs to be administered at a different time in the disease course:

1. Drugs that boost the immune response early on (monoclonal antibodies)
2. Antiviral drugs
3. Steroids that suppress the immune system for the sickest hospitalized patients
4. Drugs that treat symptoms of COVID, such as blood clots

For COVID, the best current antiviral treatment, and the only Food and Drug Administration-approved drug, is remdesivir. Remdesivir slows down the virus and was proven to benefit the patients sickest with COVID. However, it has its limitations.

It can only be administered intravenously, ruling out any non-hospitalized COVID patients. Doctors have also had a hard time finding out who benefits from remdesivir in such a heterogeneous population that visits the hospital. COVID patients who don’t require hospitalization hang back from the hospitals until it becomes more severe.

A bottle containing the drug remdesivir is shown by a health worker at the Institute of Infectology of Kenezy Gyula Teaching Hospital of the University of Debrecen in Debrecen, Hungary, Thursday Oct. 15, 2020. (Zsolt Czegledi/MTI via AP)


By the time patients receive remdesivir, Ray said:

People have enough severity that they’re going to benefit from any treatment because there’s a fair number of people who will get better regardless. So, the drug is not going to look like it works in a group that’s going to get better anyway.

Furthermore, remdesivir is expensive and limited. Ray added that doctors treating patients at bedside aren’t doing a clinical trial — they prioritize the most vulnerable to treat them and make them well again.

The steroid dexamethasone was proven to be dramatically effective in the sickest patients. It still serves as the strongest tool to prevent death and is cheap and easy to use. Hydrocortisone is another equally effective steroid and budesonide, a steroid commonly used to treat asthma, is another one that could help people with early COVID symptoms recover at home.

FILE - This Saturday, March 6, 2021 file photo shows vials of Johnson & Johnson COVID-19 vaccine at a pharmacy in Denver. (AP Photo/David Zalubowski, File)


Convalescent plasma — plasma from people who recovered from COVID — helps too, but only early on. Once the virus changed, that method became less effective.

The investigational monoclonal antibody therapy bamlanivimab had emergency use authorization (EUA) from the FDA, but it was later revoked when it was discovered that the benefits "no longer outweigh the known and potential risks for its authorized use."

However, combinations of other monoclonal antibodies — what doctors call “cocktails” — have shown good activity against the delta variant and are less susceptible to variant changes. These combinations are designed for patients who failed to make their own natural antibodies to fight the virus.

Tocilizumab and sarilumab are two anti-inflammatory medications that can reduce deaths and length of hospital stays.

The other proposed drugs — hydroxychloroquine, chloroquine, ivermectin and other antacids — gave people hope in vitro, Ray said.

When it came to real trials, they did not prove to be effective. Scientists found that many drugs that targeted sigma receptors (proteins that interact with some of the virus’s proteins) didn’t improve COVID-19 symptoms. There was no relationship between the drug’s ability to grab the sigma receptors and its effectiveness against the virus when tested on cells grown in lab dishes. The drugs did one or the other, but couldn’t do both.

 

[Stimulus mind]

Jay Vojno gets the Johnson & Johnson COVID-19 vaccine, Friday, July 30, 2021, in New York. (AP Photo/Mark Lennihan)


When it comes to ivermectin, many doctors have prescribed it despite a statement released by the drug's maker Merck, that there is no scientific basis for a potential therapeutic effect of the drug against COVID-19, but there is a “concerning lack of safety data in the majority of the studies.”

Ray said health care workers would “jump at an inexpensive, safe drug that treats COVID,” but there is not any credible evidence that ivermectin works for COVID. Many publications on it have been retracted, but the drug continues to be controversially promoted for use in Latin America and South Africa despite the lack of hard evidence.

A number of hurdles slow the process of a clinical trial. Ray said doctors haven’t had enough trial participants in the same stage of the virus to ensure well-composed trials, considering pandemic cases lessened in February and March. Unfortunately, he said, the delta variant will allow for more comprehensive clinical trials, which could accelerate the development of an antiviral treatment, potentially in six to 12 months.

The nature of COVID brings its own challenges to the table. Running a trial of patients early in the course of their disease is likely when an antiviral works best.

FILE - In this March 2020 photo provided by Gilead Sciences, rubber stoppers are placed onto filled vials of the investigational drug remdesivir at a Gilead manufacturing site in the United States. (Gilead Sciences via AP)


This, of course, is difficult with a virus that doesn’t show symptoms for days. By the time patients experience symptoms, they’re five to 14 days into the illness. However, these patients are following public health messaging by staying home if they’ve been infected. Once they’re in the hospital, they likely won’t agree to a clinical trial that could possibly give them a placebo instead of a real drug.

With all this being said, treatment trials are underway. Merck announced their investigational oral therapeutic molnupiravir — which mimics a block of RNA and interferes with replication, like remdesivir but in pill form — showed promising results in its phase 2/3 trial. The U.S. government has agreed to buy 1.7 million courses of it if it’s granted EUA by the FDA.

However, a monetary commitment doesn’t mean the antiviral will work. Ray said one of the reasons COVID vaccines were developed and rolled out so quickly was because the companies weren’t afraid of making the investment with the government fronting the costs. Right now, development is in the works, but still in vitro, which doesn’t tell health officials much about their efficacy.

Furthermore, as the CDC has outlined, COVID is moving quickly — likely quicker than the vaccine now.

The more we let [COVID] run wild, the more it’s going to diversify, and it’ll be ready for any drug we throw at it,” Ray said. “When we use a drug, its ability to evade that drug is going to be dependent on how diverse it is. So, what we want to do is limit its diversity.

On the bright side, he said the dominance of the delta variant could be working in humanity’s favour since doctors can target delta. That is — until the next thing comes along.

Looking ahead, the Johns Hopkins expert said things have moved very rapidly with COVID, from trials to prevention developments, so more clinical trial results will likely be coming out in the next few months, especially because of the increasing number of COVID cases. He said some drugs may be modestly effective, but he doesn’t see any “showstoppers.”

Treatment is the least impactful thing we could do,” he said. “No epidemic in history has been managed with treatment. It’s always vaccines that get us out of trouble. “A virus is just a program that gets into our cells and tells them to do something. We really have a hard time separating what the virus does from what the cell does, so antivirals are a really hard test. We have not historically had many of them. But I think we have in hand the solution if we grab it, and its name is vaccine, and I don’t make a dime from these vaccines. I just want to stop this pandemic. And the way to get there is the vaccine.

Source: nbcmontana.com

 

[batwise]

Johnson eka approve karalada WHO eken?

 

[Sri_Sampath]

Tocilizumab and sarilumab are two anti-inflammatory medications that can reduce deaths and length of hospital stays.

The other proposed drugs — hydroxychloroquine, chloroquine, ivermectin and other antacids — gave people hope in vitro, Ray said.

පොහොට්ටුවේ බුධ්ධිමතාගේ බෙහෙත.
කලින් උන් ම (සුද්දෝ) නේ බන් වැඩක් නෑ කිවේ

කාලකන්නි - ඕක ගොඩක් ගාන අඩු බේතක්

 

[Stimulus mind]

Johnson eka approve karalada WHO eken?

mn hithanne thama na.eth india we approve karanna illala thiyanawalu. thama theeranayak na.

Johnson and Johnson’s Covid-19 vaccine has another problematic rare side effect

 

[batwise]

mn hithanne thama na.eth india we approve karanna illala thiyanawalu. thama theeranayak na.

Johnson and Johnson’s Covid-19 vaccine has another problematic rare side effect

Mage yaluwk innawa, German company ekakata aithi nawaka wada krnne. Single does hinda e නැව් වල අයට ඒක විඳිනවා qwwa lu, tama na habai.

 

[PHBhagya]

බම්ප්

 

[hodakolla]

BUMPER

 

[castellain]