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Overshadowed by the global vaccine push, the search for treatments for Covid-19 has made steady – albeit slower – progress.
Here’s a look at what works, what might work, and what definitely doesn’t.
Proven therapies
The World Health Organization (WHO) has approved three types of Covid-19 treatment.
The first is a class of steroids called corticosteroids, recommended in September 2020 by the UN health authority, which said it should only be used by critically ill patients.
Inexpensive and widely available, the steroid fights the inflammation that typically accompanies severe cases, reducing the need to be placed on a ventilator and the risk of death.
The WHO has also approved two known arthritis drugs – tocilizumab and sarilumab – which have been shown to suppress a dangerous overreaction of the immune system to the Sars-CoV-2 virus that causes Covid.
The two drugs, approved in July, also reduce the risk of death and the need for ventilators.
And last week, the WHO recommended Regeneron, the expensive cocktail of synthetic antibodies given to former US President Donald Trump upon contact with the virus.
But he said it should only be used in patients with specific health profiles, for example with non-severe Covid who are still at high risk of hospitalization.
Critically ill patients who cannot develop an adequate immune response can also take the antibody combo, the WHO said.
Read: Regeneron Covid-19 Therapy Reduces Deaths in Hospital Patients Who Lack Antibodies: Study
Therapies tested
Several laboratories are working on antiviral drugs that can be taken orally in pill form.
One of the most advanced is molnupiravir, an experimental therapy developed by Ridgeback Biotherapeutics and Merck that aims to prevent the virus from replicating.
Currently in phase 3 trials, the drug is being tested on Covid patients and also as a preventive measure for contact cases. The results are expected by the end of the year.
Atea Pharmaceuticals and Roche Laboratories are evaluating a similar treatment.
Vaccine maker Pfizer is also working on a drug that combines two molecules, one of which is already used to fight HIV.
The market for treatments “effective and easy to administer against early forms of Covid is potentially huge”, estimates infectious disease specialist Karine Lacombe.
So far, antiviral drugs have not been very effective against Covid.
Read: In the race to find a Covid-19 treatment pill
In May, the United States Food and Drug Administration granted sotrovimab – a new monoclonal antibody therapy developed by GSK – emergency use authorization for the treatment of mild to moderate Covid-19.
The European Commission then ranked it among the five most promising treatments for the disease.
AstraZeneca published the preliminary results of its antibody cocktail at the end of August, claiming that it could prevent Covid in fragile patients.
And the French company Xenothera is working on another type of synthetic treatment called “polyclonal antibodies”. Its therapy, based on pig antibodies adapted to the human immune system, is in the final phase of clinical trials.
What does not work
Hydroxychloroquine, remdesivir, ivermectin, and the anti-HIV drug lopinavir-ritonavir (Kaletra), have all been shown to be ineffective against Covid-19, according to multiple studies and trials.
Despite this, demand for these drugs as Covid treatments remains high, fueled in large part by shady or fraudulent claims on social media.
The researchers had hoped to “reposition” these drugs – to try them on Covid patients even though they were created to fight other conditions.
“Repositioning a drug is what you do in an emergency at the very start of a pandemic,” Lacombe said.
But the fact that no therapy could be reused – other than anti-inflammatory arthritis drugs – shows the limit of this kind of approach, she said.
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