Merck COVID-19 oral drug can not reduce the risk of hospitalization

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Merck COVID-19 oral drug can not reduce the risk of hospitalization

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Large-scale study shows Merck COVID-19 oral drug can not reduce the risk of hospitalization, small molecule drugs are questioned　　

Taking Merck’s oral drug molnupiravir, which shortened the recovery time of patients, did not show any benefit in reducing hospitalizations compared with the placebo group.

Can the COVID-19 small molecule oral drug reduce the risk of hospitalization?

Merck’s oral antiviral drug for Covid-19 did not reduce the risk of hospitalization and death in adults at high risk for Covid-19, according to the results of a large-scale UK clinical trial published recently.

Preliminary results of a clinical trial of more than 25,000 people released on Thursday showed that taking molnupiravir, an oral anti-coronavirus drug developed by Merck and its partner Ridgeback, can shorten the recovery time of patients.

But the drug did not show any benefit in reducing hospitalizations compared with the placebo group.

Reduced critical illness rate due to Omicron

Chris Butler, a researcher at Oxford University who led the study, said there was “no difference” between taking the drug and a placebo when hospitalizations were relatively low during Omikoron’s infection. But he doesn’t think the research is a failure.

A Chinese clinical expert also told the First Financial Reporter that this result is not surprising, because the disease caused by Omicron infection is weaker than the previous COVID-19 variant, and the severe and fatal rates have been reduced.

Ma Dawei, an academician of the Chinese Academy of Sciences, also previously told the reporter: “Drug research and development is intended to serve clinical purposes.

If the drug cannot be proven to reduce the risk of severe illness, but only shorten the time to turn negative, then the importance is also important. Great discount.”

According to the clinical trial results of Monoravir previously filed in the United States, the effectiveness in reducing the risk of severe hospitalization for the COVID-19 is 50%.

A subsequent updated clinical study showed the drug’s effectiveness in reducing the risk of severe COVID-19 hospitalization dropped to 30 percent.

The results of early clinical trials of some drug therapies have been encouraging, but the results of large-scale clinical trials have been disappointing, which is not uncommon during the COVID-19 epidemic, such as remdesivir.

In the updated COVID-19 treatment guidelines released in March this year, the WHO conditionally recommended monogravir.

According to WHO recommendations, monogravir should only be given to non-severe COVID-19 patients with the highest risk of hospitalization, including the unvaccinated, the elderly, immunocompromised and chronically ill patients.

In March of this year, it was mentioned in the COVID-19 diagnosis and treatment plan in the United States that the preferred therapy for confirmed patients is still Pfizer’s Paxlovid, sostovizumab or remdesivir.

Monoprevir should only be considered if the above 3 drugs are not available or if there are clinical contraindications (drug-drug interactions, kidney and liver problems, etc.).

Although monogravir is not widely used, it has still generated more than $5 billion in sales since the drug was approved. In the U.S., a course of Merck’s monogravir costs about $700, higher than Paxlovid’s $530 course.

The latest clinical trial results also put a question mark on whether the drug can continue to be used in the future.

Pfizer tries to explain why patients’ symptoms rebound

In fact, since the launch of the COVID-19 small molecule oral drug, doubts have never ceased. Even Paxlovid, the most widely used Pfizer antiviral drug in the world, is facing doubts.

The biggest doubt about the drug is that some patients have experienced a rebound in COVID-19 symptoms after stopping the drug.

Researchers at the National Institutes of Health (NIH) tried to explain why some patients’ symptoms rebounded not because of medication. 

A rebound in symptoms in patients may be related to a robust immune response, according to a small study published Thursday in the journal Clinical Infectious Diseases.

The National Institutes of Health conducted an in-depth study of eight COVID-19 patients who experienced symptom rebound and concluded that these patients did not need to take longer courses of medication to reduce the risk of symptom recurrence because those who experienced symptom rebound Antibody levels are higher.

However, the study did not provide a causal link between elevated antibody levels and symptom rebound.

Previously, U.S. President Biden and Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, both experienced a rebound in COVID-19 symptoms after taking the drug.

Some experts have speculated that this is because the drug interferes with the immune response in some patients, but the latest research refutes this hypothesis, arguing that the patient’s rebound in symptoms is not caused by the virus re-replicating in the body after the drug is stopped.

However, the researchers say larger and more detailed studies are needed to better understand the real reasons behind the rebound in patients’ symptoms, especially in patients whose immune responses are suppressed, to evaluate the efficacy of longer courses of Paxlovid.

At present, some countries have approved COVID-19 small molecule drugs include Pfizer’s Paxlovid.

However, due to the weakened pathogenicity of Omicron and the low rate of developing severe/critical illness or death, it is difficult to observe the improvement in clinical outcomes of drugs in the clinical stage, which brings challenges to the validation of drug effectiveness .

Hong Kong study: COVID-19 oral medication reduces risk of death

After the fifth wave of the outbreak in Hong Kong at the beginning of the year, the Chinese University School of Medicine and the Li Ka Shing School of Medicine of the University of Hong Kong provided two oral antiviral drugs to COVID-19 patients; between February and March, they studied 54,355 patients, of whom two Cheng received oral medicine.

Two universities announced today that a team of researchers found that hospitalized patients who took either of the oral drugs had a lower risk of death than those who did not.

According to the announcement, the two oral drugs are Nirmatrelvir-Ritonavir, a two-component oral antiviral drug developed by Pfizer in the United States under the brand name “Paxlovid”, and “Monapiravir”  from Merck & Co.

The study pointed out that if a single calculation of belavir can reduce the risk of death by 90%, it is 69% for monapiravir.

The research team pointed out that although Beiravir can be more effective in reducing the risk of death and hospitalization, it is easy to interact with other drugs and is not suitable for patients who are taking drugs such as anticoagulants or antibiotics; Monapilavir and other drugs The possibility of mutual influence is low.

The findings have been published in the medical journal The Lancet.

Large-scale study shows Merck COVID-19 oral drug can not reduce the risk of hospitalization, small molecule drugs are questioned

(source:internet, reference only)

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