The experimental drug Molnupiravir has brought fresh hope to the fight against Covid-19. Medical News Today explored the evidence to see whether this optimism is justified.
Merck’s global trial
A global trial, led by the pharmaceutical company Merck — known as MSD outside the United States and Canada — and Ridgeback Therapeutics, has found that the companies’ experimental antiviral drug molnupiravir reduces the risk of hospital admission or death from COVID-19 by approximately 50%.
Risk factors included obesity, an age of over 60 years, diabetes, and heart disease.
The scientists allocated each of the 775 participants randomly to one of two groups.
Merck plans to produce 10 million courses of treatment in 2021 and more in 2022.
The study results have been greeted with optimism.
What is molnupiravir?
Molnupiravir belongs to a class of antivirals called mutagenic ribonucleosides.
The mutation stops the virus from replicating.
This keeps numbers of the virus in the body low and should reduce the severity of the disease.
Remdesivir, an intravenously administered drug that interferes with an enzyme essential for replicating viral RNA, showed early promise.
At a projected cost of around $700 per person for a 5-day course, it is also more affordable than other drugs.
Safe and Affordable
Prof. Sir Peter Horby, a professor of emerging infectious diseases and global health at the University of Oxford, is largely optimistic: “A safe, affordable, and effective antiviral would be a huge advance in the fight against COVID.”
However, he retained a note of caution: “It is important to remember that the absolute risks were 14% reduced to 7%, so quite a lot of people need to be treated to prevent one hospitalization or death.”
“This means the drug needs to be very safe and affordable.”
“In practice, there is usually a lower success rate than in clinical trials.”
“Unless an antiviral medication could be made so cheap and so safe that it can be used ‘on spec’ by people who might have COVID-19, unlikely to be widely useful,” he adds.
Side Effects
Despite widespread optimism following the study results, some experts have raised concerns about the safety of a drug that works by causing mutations.
One study in animal cell cultures found mutations in cells treated with molnupiravir.
Additionally, they recommend monitoring to assess potential genotoxic side effects.
Prof. Schaffner was less concerned about the possible genetic implications: “The FDA would certainly not have permitted clinical trials in humans if they thought there was any reasonable danger.
Animal studies showed no adverse effects.”
Proven to be Effective
In this trial, molnupiravir was effective against all variants, including the Delta variant, which was shown in a recent study to have a 235% increased risk of intensive care unit admission, compared with the original variant.
A previous trial showed no benefit in giving the drug to patients already in hospital with COVID-19.
As an early treatment, molnupiravir could, Prof. Schaffner agrees, “offer another opportunity to prevent serious disease.”
“So, is molnupiravir the drug we have been waiting for to bring COVID-19 under control?”
“Perhaps, but the evidence is not yet conclusive.”
“We are told there were few side effects, but it would be good to know more details and see a fully peer-reviewed publication,” he said.
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Source: Medical News Today
