The other day, the American pharmaceutical company Merck & Co together with Ridgeback Biotherapeutics announced the successful development of the first coronavirus pill, which halves the risk of death. The drug was named after the hammer of Thor, Mjölnir - Molnupiravir. According to the plan, the drug should become a “hammer from SARS-CoV-2” and new aggressive mutations.
An independent commission that monitored trials involving people at high risk of serious consequences advised to stop the study early because Molnupiravir showed a positive result. The company has already applied for approval of the drug with the US Food and Drug Administration.
In addition to Merck, similar drugs from Covid-19 are created by Pfizer and Roche, and new treatments for coronavirus may soon appear on the market. Why everyone is waiting for the appearance of coronavirus pills, how they work and whether they can completely replace vaccines in the fight against the pandemic is explained below.
Why is there so much attention around the drug?
If approved, Molnupiravir will be the first simple coronavirus pill that at-risk patients will be able to take at home, according to the BBC.
Other drugs, such as dexamethasone, are already saving the lives of sick patients, but specifically in hospitals because they need to be given as injections or intravenous infusions. Medication should protect patients from serious illness, and at home medication should reduce the burden on the hospitals. This could potentially save the healthcare system millions of dollars. Molnupiravir should be taken immediately after the onset of symptoms in the early stages of infection.
Daria Hazuda, the company's vice president, said that “an antiviral treatment for people who are not vaccinated, or who are less responsive to immunity from vaccines, is a very important tool in helping to end this pandemic.”
Merck already has competitors - other companies are also working on similar treatments. An American competitor, Pfizer, recently began testing two different antiviral pills, as did Swiss company Roche. The results of clinical trials of these two pills are expected in the next few months.
How does it work?
The pill was originally designed to treat the flu. It makes mistakes in the genetic code of the virus and prevents it from spreading in the body.
Unlike most Covid-19 vaccines, which target the adhesion protein outside the virus, the treatment works by targeting the enzyme that the virus uses to make copies. The main difference between Molnupiravir and vaccines is that the pill resists the pre-existing infections instead of reducing the risk of coronavirus infection.
The drug is expected to be taken four capsules twice a day for five days - only 40 tablets per course of treatment.
Merck has said it should make the pill just as effective against new variants of the virus as it mutates in the future.
The study was released in a press release on Friday and has not yet been peer reviewed. However, an independent group of medical experts monitoring the study recommended that it be stopped early.
Early studies show that the drug can reduce the numbers of hospitalizations and mortality by approximately 50% in patients with mild to moderate severity. The study involved 775 unvaccinated adults with Covid-19 with mild to moderate severity. They were considered more at risk for serious illness due to health problems such as obesity, diabetes or heart disease.
“It exceeded what I thought the drug might be able to do in this clinical trial. When you see a 50% reduction in hospitalisation or death, that’s a substantial clinical impact,” said Dean Li, the vice-president of Merck research.
Half of the subjects were prescribed a five-day course of tablets. 53 patients (14%) in the placebo group were hospitalized compared to 28 (7%) of those receiving the drug. According to Merck, there were no deaths in the pill group after this period, compared with 8 deaths in the placebo group.
However, caution is required, as with a relatively small number of participants, the performance may fluctuate.
A side effect
The incidence of drug-related side effects was similar in the Molnupiravir group and the placebo group. Mild side effects, such as headaches, were reported with equal frequency in both groups (with the real drug and placebo). These rates are 12% and 11% respectively.
Other data on side effects have not yet been released, it will be key to finding out how widely the drug can be used.
When can mass use begin?
The pill may be available in the United States several months after it is found to halve hospitalizations and deaths. The US government has already purchased 1.7 million doses of the drug for $1.2 billion.
Merck is also going to seek permission to use the drug in other countries. The company said it would use a “multi-level approach to pricing” to reflect countries' ability to pay for the drug.
Will the pill end the pandemic? No, only vaccines
The appearance of such drugs should not cause complacency. Vaccines remain the most effective tool to end this pandemic, The Bloobmerg reports.
If the new Molnupiravir pill is seen as a solution for those who refuse to be vaccinated, Covid-19 will not go away. And if the virus continues to circulate, new mutations can occur that could potentially make vaccines less effective than they are.
Undoubtedly, Molnupiravir can be a solution for many patients. But first and foremost, vaccination can prevent Covid-19 infection, not just treating patients when they become infected.