US drug maker Merck announced that its experimental drug Molnupiravir could be a viable treatment option for severe Covid-19.

Merck is seeking permission to apply for emergency use authorization for the drug with the United States Food and Drug Administration (FDA).

If approved, the pill would be the first oral drug to treat Covid-19 infections.

Since last year, there have been various drugs considered promising to treat Covid-19. However, several studies — including the WHO’s “Solidarity Trial” in dozens of countries – stated that these drugs have not been shown to provide significant benefits.

According to Professor Tjandra Yoga Aditama, Director of the Postgraduate Program at YARSI University/Professor at the Faculty of Medicine, University of Indonesia (FKUI), the WHO regularly updates its treatment recommendations based on the latest scientific evidence.

The latest WHO treatment guidelines “WHO Therapeutics and COVID-19: living guidelines” was just published on September 24, 2021.

“Providing recommendations (some are conditional and some are strong) on several combinations of neutralizing monoclonal antibodies (namely casirivimab and imdevimab, interleukin 6 receptor blockers (IL-6 receptor blockers), namely tocilizumab or sarilumab and corticosteroids,” said Tjandra in a statement.

“A lot of research has also been done on anti-viral drugs that don’t require injection, in oral form only,” he added.

Tjandra stated that in January 2021 for example, the US Department of Health and Human Services announced an investment of $3 billion to create new Covid-19 drugs, mainly in oral form.

Last Friday, Merck announced the results of their research on their Molnupiravir drug.

Here are the facts about the Molnupiravir pill which is claimed to reduce the risk of severe symptoms of Covid-19.

1. Reducing treatment rates and risk of death

On October 1, 2021 drug makers Merck and Ridgeback announced the results of their experimental drug, Molnupiravir (MK-4482, EIDD-2801).

According to Tjandra, the results of the interim study show that Molnupiravir can reduce the number of hospitalizations by 50 % and also prevent deaths from Covid-19 in patients with mild and moderate cases.

In this study, Molnupiravir was administered to 385 people. Of these, 7.3 % of patients (28) were hospitalized until day 29 of the study.

Meanwhile, 377 patients did not receive Molnupiravir or only received a placebo. Of these, 53 people (14.1 %) were admitted to the hospital, approximately double the number.

“In addition to hospital admission, 8 people who did not receive Molnupiravir died, while none of those who received Molnupiravir died until the 29th day of this study,” said the former WHO Southeast Asia Director and former Director General of P2P & Head of the Health Research and Development Agency (Balitbangkes).

The study was performed on Covid-19 patients with mild and moderate symptoms, with symptoms lasting for a maximum of five days, previously lasting for up to seven days.

2. Consistent for various Covid-19 variants

Tjandra revealed that the results of this study also showed that the efficacy of Molnupiravir was consistent with the various variants found, namely Gamma, Delta, and Mu, in 40 %of the sample data.

3. Molnupiravir side effects

In general, the side effects were nearly equal between those that took Molnupiravir and a placebo, between 35 % and 40 %. According to Tjandra, Molnupiravir was studied in patients who had at least one disease risk factor, or commonly known as comorbidity.

“The most common are obesity, diabetes mellitus, heart disease and also old age (> 60 years),” said Tjandra.

4. Drug trials halted

In April, clinical trials of the Molnupiravir drug in hospitalized patients were discontinued due to lack of good results.

“Back in April, it was decided that the research would be continued only on those who had not yet been admitted to the hospital, the results of which were only announced on October 1,” said Tjandra.

5. Efforts are being made to obtain an emergency use permit

As reported by Reuters, Merck and partner company, Ridgeback Biotherapeutics, are currently seeking approval from the FDA for emergency use in the United States.

“This will change the conversation about how we control Covid-19,” said Merck CEO Robert Davis.

According to senior researcher at the Johns Hopkins Center for Health Protection, Amesh Adalja, if proven effective, the Molnupiravir pill will change the way the world deals with Covid-19 and also make competition between global pharmaceutical companies even more intense.

“Current treatment is not easy and quite inconvenient in terms of logistics. A drug in the form of a pill will change everything,” said Adalja.

Author: HL

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