The Coronavirus Disease 2019 (COVID-19), which emerged in Wuhan, a city of 11 million in Hubei province, has spread to more than two dozen countries, taking the lives of more than 2,800 people.
As per the WHO, "Harnessing the power of science is critical for bringing this outbreak under control." Ever since the outbreak, research teams and pharma companies are striving to develop treatments and vaccines to fight the deadly virus.
Looking at the criticality of the situation, and the rapid phase at which the virus is spreading, quick access to the right treatment is the need of the hour. To cut down the development timeframe, many companies are repurposing existing drugs as they have established pharmacodynamic and pharmacokinetic data.
Zhejiang Hisun Pharmaceutical's Favilavir (Favipiravir)
Zhejiang Hisun Pharmaceutical's Favilavir (Favipiravir), an antiviral drug, has secured approval from the National Medical Products Administration of China as an investigational therapy for coronavirus. As per China's Ministry of Science and Technology, Favilavir has demonstrated encouraging results in early clinical trials against the COVID-19.
Apart from Favilavir, the anti-malaria drug chloroquine and Gilead's investigational drug remdesivir are the next rays of hopes against the deadly virus.
Anti-malaria drug Chloroquine
Chloroquine, a well-known anti-malarial medicine, has shown apparent efficacy and acceptable safety against COVID-19 associated pneumonia in multicenter clinical trials in China. In addition to its antiviral activity, chloroquine has immune-modulating properties, which may synergistically enhance its antiviral effect.
Chloroquine is recommended to be included in the next version of the “Guidelines for the Prevention, Diagnosis, and Treatment of Pneumonia Caused by COVID-19” issued by the National Health Commission of the People's Republic of China for treatment of COVID-19 infection in larger populations in the future.
Remdesivir by Gilead Sciences - Trials are being performed in multiple hospitals in Wuhan
Remdesivir developed by Gilead Sciences was originally being developed to treat Ebola. The drug is not licensed or approved anywhere in the world.
A study by the US National Institutes of Health (NIH) found that remdesivir prevents Middle East respiratory syndrome coronavirus (MERS-CoV) in monkeys. These results supported testing remdesivir against the COVID-19. The drug is being advanced into human clinical trials for coronavirus treatment in China.
As per a report by the New England Journal of Medicine (NEJM), remdesivir was administered to the first coronavirus patient in the United States after his condition worsened, and he developed pneumonia. Remdesivir appeared to have improved the patient's clinical condition, and this, in turn, has encouraged further clinical studies of this medication.
Remdesivir is being tested on 761 patients in a phase III randomized trial in partnership with China. The trials are being performed in multiple hospitals in Wuhan.
Remdesivir has intellectual property barriers in the country; as per the Wuhan Institute of Virology, remdesivir would enter major countries around the world through the Patent Cooperation Agreement (PCT) approach. The Wuhan Institute of Virology has filed an application seeking a new patent on remdesivir in January 2020.
AbbVie's HIV drug Kaletra
Health authorities in China are using AbbVie's HIV drug Kaletra, a combination of lopinavir and ritonavir, for the treatment of infected patients. Kaletra has previously been investigated in patients with Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS), which belongs to the same family of virus as COVID-19.
Kaletra works by blocking a protease that is indispensable for the COVID-19 to reproduce in the human body. Though Kaletra was designed to block a different protease, reports suggest it may be efficient to delay disease progression and treat the symptoms associated with the COVID-19.
Biocryst Pharma's Galidesivir - A potential antiviral for coronavirus treatment
Galidesivir, an antiviral drug, is a nucleoside RNA polymerase inhibitor that disrupts the process of viral replication. Galidesivir has shown broad-spectrum activity against a wide range of pathogens, including coronavirus.
Galidesivir has already shown survival benefits in patients against deadly viruses such as Ebola, Zika, Marburg, and Yellow fever and proven to be safe in healthy volunteers. Galidesivir has demonstrated broad-spectrum activity (in vitro) against more than 20 ribonucleic acid (RNA) viruses in nine different families, including filoviruses, togaviruses, bunyaviruses, arenaviruses, paramyxoviruses, coronaviruses, and flaviviruses.
Brilacidin by Innovation Pharmaceuticals has demonstrated antiviral properties in preclinical studies
Innovation Pharmaceuticals is evaluating Brilacidin, a defensin mimetic drug candidate, as a potential treatment for coronavirus. Brilacidin is a small molecule in late-phase development, which has demonstrated antibacterial, anti-inflammatory, and immunomodulatory properties in various clinical trials.
The drug is actually being investigated for inflammatory bowel disease and oral mucositis in cancer patients. As per company reports, the drug has demonstrated antiviral properties in preclinical studies, and further optimization, formulation, and delivery analysis may be required to make the drug trigger a response against the coronavirus.
CytoDyn is examining leronlimab, a CCR5 antagonist, as a potential coronavirus drug
CytoDyn is preparing to test leronlimab in treating COVID-19. As per CytoDyn, the drug may work with other retroviral drugs being used to treat the virus.
Leronlimab, a C-C chemokine receptor type 5 (CCR5) antagonist, is being investigated in phase II clinical trials as a treatment for HIV. Leronlimab is under development to treat various conditions, designed to boost the cellular immune response, block the antiviral T-cell responses and repolarise the macrophage activity.
BXT-25 - An investigational drug for acute respiratory distress syndrome
Bioxytran is planning to develop its investigational drug, BX-25, as an option to treat acute respiratory distress syndrome (ARDS) in late-stage patients infected with the coronavirus.
BTX-25 is a glyco-polymer made of hybrid molecules of HEME chemical structure taken from the hemoglobin molecule and a proprietary polymer chemical structure. The drug is administered intravenously and acts as a therapeutic to deliver oxygen to tissues in the body.
Most of the late-stage coronavirus patients develop ARDS, in which the diffusion of oxygen to the blood is compromised; this leads to fluid accumulation in the lungs. BXT-25 can help in supplying oxygen to the vital organs, which will supposedly offer enough time for the patient to recover, and, over time, the body's immune system will destroy the virus.
Regeneron's monoclonal antibodies
Regeneron's neutralizing monoclonal antibodies REGN3048 and REGN3051 combo is being explored against coronavirus infection in a first-in-human clinical trial.
The antibodies bind to the S-protein of MERS coronavirus. The administration of the antibodies in mouse model of MERS resulted in the high-level neutralization of the MERS coronavirus in circulating blood with reduced viral loads in the lungs.
The trial sponsored by the National Institute of Allergy and Infectious Diseases (NIAID) will evaluate the safety and tolerability of the drug in 48 coronavirus patients.
RNA interference (RNAi)-based prophylactics and therapeutics by Sirnaomics
Sirnaomics aims to develop RNA interference (RNAi)-based prophylactics and therapeutics for COVID-19. The small interfering RNA (siRNA) selectively acts on the genes required for viral infection and replication. The company has previously used siRNA based drugs to treat SARS coronavirus, H5N1 influenza, and other respiratory viral infections.
Urgent need for an effective treatment
The deadly nature of the COVID-19 underlines the urgent need for an effective treatment - all eyes are on the next possible treatment option for the virus. Researchers and companies are also striving to produce a vaccine candidate to be ready for human clinical trials; however, developing a potential vaccine is an artisanal affair, and there is no guarantee whether it would take months or years.
About the Author:
Neeta Ratanghayra is a freelance medical writer, who creates quality medical content for Pharma and healthcare industries. A Master’s degree in Pharmacy and a strong passion for writing made her venture into the world of medical writing. She believes that effective content forms the media through which innovations and developments in pharma/healthcare can be communicated to the world."
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