Most Covid-19 treatments fall under three broad categories, antivirals that prevent the virus from multiplying, immune-modulators that regulate the immune response, and combinations that use multiple mechanisms of action.(AP)
Most Covid-19 treatments fall under three broad categories, antivirals that prevent the virus from multiplying, immune-modulators that regulate the immune response, and combinations that use multiple mechanisms of action.(AP)

As vaccine trials end, where do Covid-19 treatments stand?

Most Covid-19 treatments fall under three broad categories, antivirals that prevent the virus from multiplying, immune-modulators that regulate the immune response, and combinations that use multiple mechanisms of action.
By Sanchita Sharma | Hindustan Times, New Delhi
UPDATED ON NOV 24, 2020 05:35 AM IST

Vaccine developers have been racing against time to find a shot that offers immunity against the coronavirus disease (Covid-19). The University of Oxford announced on Monday that its vaccine against the viral disease was up to 90% effective in preventing infection, Pfizer Inc. filed for emergency use authorization in the US for its vaccine that showed 995% efficacy last Friday, Moderna said its vaccine was 94.5% effective, even as Hyderabad-based Dr Reddy’s Laboratories got ready to begin late stage trails of Russia’s Sputnik V in India this week. Parallelly, major treatment protocols are being revised following results from several global trials that cleared the air on which Covid-19 therapies work better than others.

Most Covid-19 treatments fall under three broad categories, antivirals that prevent the virus from multiplying, immune-modulators that regulate the immune response, and combinations that use multiple mechanisms of action.

Antiviral remdesivir

The antiviral remdesivir was suspended from the World Health Organization prequalification list that developing countries use as a benchmark for procurement. The suspension followed the health agency’s guidance on Friday against the use of remdesivir in hospitalized patients, regardless of disease severity, after an international guidelines development group found no evidence that the drug improves survival rates, reduces the need for mechanical ventilation, or boosts recovery and other patient outcomes. The group, however, recognized that more research was needed, and supported continued enrolment in trials evaluating remdesivir.

“The guidelines group of WHO is separate from Solidarity Trial group as it reviews all evidence, including the WHO trial. They have concluded that there is no evidence of benefit from (remdesivir) in any group of hospitalised patients and that available evidence is inadequate if there is a benefit in non-hospitalised patients. As such, corticosteroids are the only class of drugs with demonstrated benefit on reducing deaths in hospitalised patients. The search for other effective modalities of treatment goes on,” said Dr K Srinath Reddy, president, Public Health Foundation of India.

Aspirin and other anti-coagulants

On the upside, the ubiquitous painkiller and blood-thinning drug aspirin was added to the UK’s Randomised Evaluation of COVID-19 Therapy (RECOVERY) trial in early November. “Clotting is a big problem [in Covid-19]. Aspirin is a widely available, cheap drug which, if it were to work, would be a huge boost,” Peter Horby, the chair of the RECOVERY trial and professor of emerging infectious diseases and global health at the University of Oxford, told joint inquiry committees from the House of Commons in the UK.

“We’re [also] seeing better use of anticoagulants — heparin and others — to prevent clotting, and one would anticipate that the introduction of dexamethasone has also had an impact. That would be something that would reduce fatality rates,” said Horby.

Monoclonal antibodies

The US Food and Drug Administration this month issued an emergency use authorisation for the investigational monoclonal antibody therapy bamlanivimab for the treatment of mild-to-moderate Covid-19 in adult and paediatric patients who are 12 years of age and older weighing at least 40 kg who are at high risk for progressing to severe disease and/or hospitalization. Bamlanivimab is not authorized for patients who are hospitalized or need oxygen therapy as it may worsen clinical outcomes.

Monoclonal antibodies are laboratory-made proteins that mimic the immune system’s ability to fight harmful antigens, such as viruses and bacteria. Bamlanivimab is directed against the spike protein of Sars-CoV-2, the virus that causes COvid-19, and works by stopping the virus from entering human cells.

The US National Institute of Allergy and Infectious Diseases’ ACTIV-5 Big Effect Trial also began trials of the monoclonal antibodies risankizumab and lenzilumab last month to determine whether they helped hospitalized patients recover faster.

Some trials fell short. In October, Eli Lilly and Regeneron Pharmaceuticals suspended their trials of monoclonal antibodies in hospitalised patients on the grounds of lack of efficacy and potential safety concerns.

Monoclonal antibodies are approved for Covid-19 treatment in India. “Monoclonal antibodies have some role in early disease, but not in patients who are on oxygen or ventilator support. Since they have a limited role in mild disease, and we know a large number of patients recover on their own, they may not really benefit that much,” said Dr Randeep Guleria, director, All India Institute of Medical Sciences (AIIMS) Delhi at HT Leadership Summit on Thursday. “We also have to consider whether we will have enough doses to offer everyone, whether the cost can be met as they are expsnsive, and whether they will be needed once the vaccines come,” said Guleria.

Anti-parasitic ivermectin

Studies have shown that the affordable and widely available drug ivermectin used to treat parasitic infections has antiviral action against the Sars-CoV-2. The use of ivermectin in doses ranging from 200 to 1200 mcg/kg body weight, for a duration of three to seven days, is showing promise in symptomatic relief and viral load reduction.

Two studies of ivermectin alone or in combination with doxycycline, found ivermectin-doxycycline combination therapy had a better success of symptomatic relief, shortened recovery duration, reduced adverse effects, and superior patient compliance compared to the hydroxychloroquine-azithromycin combination in mild to moderate cases of Covid-19 disease. A retrospective study of 280 patients treated with ivermectin against standard of care found fewer deaths in the ivermectin group.

In India, ivermectin is part of at least five ongoing trials, according to Clinical Trials Registry India, and its benefits are under review.

SHARE THIS ARTICLE ON
app
Close
The Centre had offered to put on hold the three laws for 12-18 months and also set up a joint committee to find solutions.(ANI/Twitter)
The Centre had offered to put on hold the three laws for 12-18 months and also set up a joint committee to find solutions.(ANI/Twitter)

Union ministers start 11th round of talks with protesting farmer unions

PTI, New Delhi
PUBLISHED ON JAN 22, 2021 01:08 PM IST
Thousands of farmers, mainly from Punjab, Haryana and western Uttar Pradesh, are protesting at various border points of Delhi for over a month now against the three laws.
Close
The Prime Minister said that today's India is not afraid of working on experiments for solving problems.(PTI)
The Prime Minister said that today's India is not afraid of working on experiments for solving problems.(PTI)

PM Modi lauds India's cricket win over Australia

ANI, New Delhi
PUBLISHED ON JAN 22, 2021 01:07 PM IST
Addressing the 18th Convocation of Tezpur University, PM Modi said that people should not be afraid of taking risks and doing experiments.
Close
Jal Shakti minister Gajendra Singh Shekhawat. (File photo)
Jal Shakti minister Gajendra Singh Shekhawat. (File photo)

HT Environment Conclave: Govt to train village women to test water quality

By HT Correspondent | Edited by Sameer
PUBLISHED ON JAN 22, 2021 01:02 PM IST
The government will put up inexpensive water-quality testing infrastructure accessible to every village to achieve the government’s mission to provide safe drinking water to all by 2024, minister Shekhawat said
Close
This comes days after Banerjee alleged that people in the Trinamool Congress (TMC) were not letting him 'work for the people'.
This comes days after Banerjee alleged that people in the Trinamool Congress (TMC) were not letting him 'work for the people'.

Bengal forest minister Rajib Banerjee resigns from post

By hindustantimes.com | Written by Susmita Pakrasi, New Delhi
UPDATED ON JAN 22, 2021 01:15 PM IST
  • Banerjee had taken to Facebook to criticise senior Trinamool leader earlier in January, saying they have not paid heed to his concerns.
Close
It is regarding the 'objectionable comments' made on social media against ministers and government officials. (Getty Images/iStockphoto)
It is regarding the 'objectionable comments' made on social media against ministers and government officials. (Getty Images/iStockphoto)

Social media posts against govt, officials to drive action by Bihar Police

ANI, Patna
PUBLISHED ON JAN 22, 2021 12:57 PM IST
The letter was released on the behalf of Economic and Cybercrime Department from Bihar Police Headquarters on January 21.
Close
Farmers shouts slogans during the farmland bill at Gazipur border.(Photo by RajkRaj)
Farmers shouts slogans during the farmland bill at Gazipur border.(Photo by RajkRaj)

News updates: Govt's strategy was to throw a net at us, says farmers' leader

By hindustantimes.com, New Delhi
UPDATED ON JAN 22, 2021 01:24 PM IST
  • Here are today’s top news, analysis and opinion at 1 PM. Know all about the latest news and other news updates from Hindustan Times.
Close
Mhada houses are in great demand as they cost less compared to private builders and have clear land titles. Image used for representational purposes only.(Pramod Thakur/HT Photo)
Mhada houses are in great demand as they cost less compared to private builders and have clear land titles. Image used for representational purposes only.(Pramod Thakur/HT Photo)

Mhada to draw lottery for over 5600 houses in Pune division

By hindustantimes.com | Edited by Deepali Sharma, Hindustan Times, New Delhi
UPDATED ON JAN 22, 2021 12:45 PM IST
The winners of the lottery will also be notified through text message and the list of the accepted applications will also be made available online on the website.
Close
Prime Minister Narendra Modi. (ANI)
Prime Minister Narendra Modi. (ANI)

Learn from India’s performance in Australia: Modi at Tezpur varsity convocation

UPDATED ON JAN 22, 2021 01:01 PM IST
“This performance by our players also teaches us big life lessons. One is to have belief in our abilities, second is to have a positive mindset. If we have a positive mindset, the outcome will also be similar,” said PM Modi
Close
Farmers protesting at Ghazipur border.(Photo by RajkRaj)
Farmers protesting at Ghazipur border.(Photo by RajkRaj)

‘Poison inside sweets’: Farmers’ leader on Centre’s offer to suspend farm laws

By hindustantimes.com | Edited by Karan Manral
PUBLISHED ON JAN 22, 2021 12:17 PM IST
The Centre wants to end protests somehow, said SS Pandher of the Kisan Mazdoor Sangharsh Committee.
Close
Representational Image.
Representational Image.

More Indians stepping out; surge in flight, hotel bookings: Report

By Neha LM Tripathi
PUBLISHED ON JAN 22, 2021 12:10 PM IST
The survey by RateGain Technologies, a SaaS company for travel and hospitality, cites the upcoming long wedding and travel season as the reasons for this surge in domestic travel
Close
Congress leaders Rahul Gandhi and Sonia Gandhi. (Sonu Mehta/HT PHOTO)
Congress leaders Rahul Gandhi and Sonia Gandhi. (Sonu Mehta/HT PHOTO)

Congress Working Committee may hold organisational elections between May 15 and May 30

UPDATED ON JAN 22, 2021 12:04 PM IST
The party is also looking at a possible window in February to hold the internal polls. Party functionaries said that a long gap between the assembly polls and the organisational elections is required so that the assembly campaign doesn’t suffer
Close
NPCI is an umbrella organisation which operates retail payments and settlement systems in India.(NPCI/Facebook)
NPCI is an umbrella organisation which operates retail payments and settlement systems in India.(NPCI/Facebook)

UPI platform to be updated, users may face inconvenience: NPCI

By hindustantimes.com | Edited by Shankhyaneel Sarkar, Hindustan Times, New Delhi
PUBLISHED ON JAN 22, 2021 11:49 AM IST
  • NPCI has not specified the time it would take to update the system.
Close
Paddy crop is being loaded on a truck after it has been procured. (Representative Photo/PTI)
Paddy crop is being loaded on a truck after it has been procured. (Representative Photo/PTI)

Chhattisgarh claims to have procured record paddy at MSP this season

By Ritesh Mishra | Edited by Abhinav Sahay, Raipur
PUBLISHED ON JAN 22, 2021 11:45 AM IST
  • The official data also shows a big increase in the total number of registered paddy farmers, which now stands at 21.52 lakh.
Close
Cambridge Analytica earlier faced allegations that it used personal information harvested from 87 million Facebook accounts to help Donald Trump win the 2016 US presidential election. (File photo)
Cambridge Analytica earlier faced allegations that it used personal information harvested from 87 million Facebook accounts to help Donald Trump win the 2016 US presidential election. (File photo)

CBI files case against Cambridge Analytica for Facebook data theft

By Neeraj Chauhan
UPDATED ON JAN 22, 2021 11:44 AM IST
The agency has found an app, authorised to collect user data for academic and research purposes, illegally collected personal data of 335 users and another 562,000 people in their friends’ network
Close
PM Modi said India is entering its 75th year of independence this year,
PM Modi said India is entering its 75th year of independence this year,

'Containing Covid-19 strengthened India's health infrastructure': PM Modi

By hindustantimes.com | Written by Susmita Pakrasi, New Delhi
UPDATED ON JAN 22, 2021 12:24 PM IST
  • PM Modi said India is entering its 75th year of Independence this year, adding that innumerable people from Assam have contributed to the nation's freedom struggle.
Close
SHARE
Story Saved
OPEN APP