AGI – Waiting for research to lead to the development of a cure or a specific vaccine against Covid-19 infection, the drugs currently used experimentally in the clinic are numerous and diverse. The 4 main drugs, protagonists of the “Solidarity Therapeutics Trial” of the World Health Organization, according to which they have little or no effects are: remdesivir, hydroxychloroquine, lopinavir / ritonavir combination and interferon-based regimens. But there are many more still in use and under evaluation.
Remdesivir is “the first antiviral drug to have obtained authorization from the European Medicines Agency (EMA) with specific indication for the “coronavirus disease treatment 2019 (COVID-19) in adults and adolescents (aged 12 years or older and weighing at least 40 kg) with pneumonia requiring supplemental oxygen therapy “, reads the website of the Italian Medicines Agency.
It is about a drug developed against Ebola and Marburg infection which works by blocking the enzyme RNA polymerase, a fundamental process for the replication of the virus within our cells.
Hydroxychloroquine is a drug developed against malaria. Its use was allowed in the early stages of the epidemic off-label use or, based on preliminary data available. “In light of the current evidence in the literature, AIFA confirms the suspension of the authorization for the off-label use of the drug outside of clinical trials”, explains the Italian drug agency.
They are two drugs used against HIV. They were used in the early stages of the epidemic but, also in this case, Aifa has decided to suspend the authorization for off-label use.
It falls into a class of drugs used within studies for try to counteract the excessive inflammatory response linked to the infection. In particular, Interferon – 1a (IFN-1a) is being studied, used for the treatment of multiple sclerosis.
It is a low molecular weight heparin and is one of the most widely used anticoagulants for the prevention and treatment of venous and arterial thromboembolism in subjects undergoing surgery or bedridden. Its use is being evaluated to counteract the alterations of coagulation and thrombotic complications in Covid-19 patients. The mechanism of action of the anticoagulant consists in attracting the virus that attaches itself to the drug molecule: the virus is thus “deceived” and, instead of attacking healthy cells, attacks the heparin.
It is an antibiotic of the macrolide family, authorized for the treatment of upper and lower respiratory tract infections, odontostomatological infections, skin and soft tissue infections, non-gonococcal urethritis, soft ulcers. There is evidence that macrolides exert beneficial effects in patients with inflammatory lung diseases, in addition to their ability to inhibit the replication of pathogenic bacteria. However, the Alpha notes that the lack of a solid rationale and the absence of evidence of efficacy does not allow recommending the use of Azithromycin, alone or associated with other drugs with particular reference to hydroxocloroquine, apart from any bacterial overlays.
It is a steroid drug, used in combination with remdesivir to treat US President Donald Trump, has been used for over 50 years against various inflammatory diseases, such as asthma, severe allergies, rheumatoid arthritis, etc. It is administered to patients in the most acute phase of Covid-19. Dexamethasone is effective in patients suffering from overactivation of the immune system, the last phase of the disease that sees the greatest damage coming no longer from the virus but from the immune system. The drug therefore extinguishes the excessive inflammation that the immune system puts in place to defend itself from Covid-19 and for this reason its use is indicated in severe patients and not in mild / moderate ones, in which its intervention would reduce the effectiveness of the immune system in attacking Sars-Cov-2.
Plasma therapy is the treatment that consists of using the plasma of patients recovered from Covid-19, therefore rich in antibodies against the new coronavirus. The experimental protocol started in Pavia and Mantua, but many cities and related centers have been added to the tests. This procedure has already been tested in China with promising results. However, the results are still mixed. New evaluations are expected.