We, the people of the world, are in a much favorable position today compared to last winter with this Covid-19 pandemic. After over 5 million reported fatalities, we have managed to enrich ourselves with more meaningful and effective tools in the armamentarium against SARS-CoV-2 virus including public health protocols, vaccines, attitude changes and, most importantly, monoclonal antibody cocktails. The real paradigm shift came from lifesaving therapeutics like Remdesivir, anticoagulants, IL-6 inhibitors and steroid treatment in severe infections. For mild to moderate infection, two novel oral antiviral pills from Pfizer (Paxlovid) and Merck/Ridgeback Biotherapeutics (Molnupiravir) were introduced this month after they garnered promising phase 3 clinical trial results. Once approved, these antivirals will revolutionize the approach to this pandemic with equitable access globally.
Merck’s Molnupiravir from Merck demonstrated 50% efficacy in preventing hospitalization and death if started early in the infection, preferably within 3 days of confirmation or clinical suspicion. This was the first oral Covid-19 pill to gain regulatory approval in the world after Britain granted conditional authorization few days ago. This antiviral, like Tamiflu (Oseltamivir) for the Influenza virus, should be taken twice a day for 5 days. Most importantly, Merck and Ridgeback Biotherapeutics agreed to allow other countries to use their formula when they signed a voluntary licensing agreement to be manufactured and used worldwide. This is an unprecedented move by Biopharma, given the lack of these agreements for Covid-19 vaccine production in resource-deprived countries thus far.
The second Covid-19 oral antiviral, Paxlovid produced by Pfizer, is a protease inhibitor —a more time-tested platform for antiviral medications. This pill is taken twice a day for 5 days by patients with mild-to-moderate infections with at least 1 risk factor for progression, and it has showed 89% effectiveness in preventing hospitalization and death from Covid-19. The data for Paxlovid has recently been submitted to FDA for emergence-use authorization. More importantly, Pfizer announced that it has working to provide equitable access to the medication for all people at an affordable price after FDA approval.
Dr. Deepthi Jayasekara
Clinical Professor of Infectious Diseases, Consultant Physician
Chair of Internal Medicine, Emanate Health hospitals