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When her husband, Joe, 46, also fell ill with the virus, she got really worried, especially for their five teenagers at home :. Who is going to raise these children? “
The next day, the couple took four tablets, twice a day. Although they were not told whether they received an active drug or a placebo, after a week, they said, their symptoms improved. Within two weeks, they had recovered.
“I don’t know if we received the treatment, but I feel like we did,” said Miranda Kelly. “To have all of these underlying conditions, I felt like the recovery was really quick.”
The Kellys have a role to play in the development of what could be the world’s next chance to thwart covid: a short-term regimen of daily pills that can fight off the virus soon after diagnosis and possibly prevent symptoms from developing afterward. the exhibition.
“Oral antivirals have the potential not only to shorten the duration of covid-19 syndrome, but also have the potential to limit transmission to people in your household if you are sick,” said Timothy Sheahan, virologist at the University. from North Carolina. -Chapel Hill who helped develop these therapies.
Antivirals are already essential treatments for other viral infections, including hepatitis C and HIV. One of the best known is Tamiflu, the widely prescribed pill that can shorten the duration of the flu and reduce the risk of hospitalization if administered quickly.
Medicines, developed to treat and prevent viral infections in humans and animals, work differently depending on the type. But they can be designed to strengthen the immune system to fight infections, block receptors so viruses cannot enter healthy cells, or reduce the amount of active viruses in the body.
At least three promising antivirals for covid are being tested in clinical trials, with results expected as early as late fall or winter, said Carl Dieffenbach, director of the AIDS Division at the National Allergy Institute and infectious diseases, which oversees the development of antivirals. .
“I think we’ll have some answers on the abilities of these pills in the next few months,” Dieffenbach said.
The main competitor is a drug from Merck & Co. and Ridgeback Biotherapeutics called molnupiravir, Dieffenbach said. This is the product tested in the Kellys’ Seattle trial. Two others include a candidate from Pfizer, known as PF-07321332, and AT-527, an antiviral produced by Roche and Atea Pharmaceuticals.
They work by interfering with the ability of the virus to replicate in human cells. In the case of molnupiravir, the enzyme that copies viral genetic material is forced to make so many mistakes that the virus cannot reproduce itself. This, in turn, lowers the patient’s viral load, shortening the time to infection and preventing the type of dangerous immune response that can cause serious illness or death.
If the results are positive and emergency use is granted for any product, Dieffenbach said, “distribution could start quickly.”
This would mean that millions of Americans could soon have access to a daily oral drug, ideally a single pill, which could be taken for five to 10 days upon first confirmation of covid infection.
“When we get there, that’s the idea,” said Dr. Daniel Griffin, an expert in infectious diseases and immunology at Columbia University. “To have it all over the country, so that people get it the same day they’re diagnosed.”
The pandemic sparked a long neglected effort to develop powerful antiviral treatments for coronaviruses, Sheahan said. Although scientists were scared of the original SARS virus in 2003 – followed by Middle East Respiratory Syndrome, or MERS, in 2012 – research efforts slowed when these outbreaks did not persist.
“The commercial drive to develop products has only collapsed,” said Sheahan.
Widely available antiviral drugs would join monoclonal antibody therapies already used to treat and prevent serious illness and hospitalizations caused by covid. Laboratory-produced monoclonal antibodies, which mimic the body’s natural response to infection, were easier to develop but must be administered primarily by intravenous infusion.
The federal government covers the cost of most monoclonal products at $ 2,000 per dose. It is still too early to know how the price of antivirals might compare.
Like monoclonal antibodies, antiviral pills would not replace vaccination, Griffin said. They would be another tool to fight against covid. “It’s good to have another option,” he said.
One of the challenges in the rapid development of antiviral drugs has been to recruit enough participants for clinical trials, each of which must enroll several hundred people, said Dr. Elizabeth Duke, a research associate at Fred Hutch overseeing his trial on molnupiravir.
Participants must be unvaccinated and enrolled in the trial within five days of a positive covid test. Every day, interns make 100 calls to people newly infected with HIV in the Seattle area – and most say no.
“Generally speaking, there is a lot of mistrust of the scientific process,” said Duke. “And some people say nasty things to interns.”
Even more promising? Studies evaluating whether antivirals can prevent infection after exposure.
“Think about it,” said Duke, who is also overseeing a prophylactic trial. “You can give it to everyone in a home or to everyone in a school. Then we talk about a return, maybe, to a normal life.”
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