Development of medicines for Covid-19
Initial reports about Covid-19 (coronavirus) first emerged in December 2019 in Wuhan city, China. Since then this virus has managed to infect lakhs of people across the globe and thousands have succumbed to it. Currently 180+ countries are suffering from its impact. The virus does not show any initial symptoms in the infected person. Moreover, no drugs have been developed till now to destroy the virus or Coronavirus vaccine to protect against it.
Biotechs, pharma, universities, research institutes and biotechs have been trying to work together, so as to create Coronavirus drug as well as to identify therapies which can help treat symptoms arising from this contagious disease.
Strategies developed to create vaccine
As per WHO, about 35 vaccines are being developed for Coronavirus treatment. The companies that have undertaken this herculean task are found to have adopted wide range of approaches including using of RNA & DNA platforms, attenuated and inactivated viruses, protein subunits and non-replicating viral vectors. As per reports, clinical development has started in the initial two vaccines.
- Moderna, the US biotech company along with NIAID (National Inst. of Allergy & Infectious Disease) on 17th March had started the first phase of the study (NCT04283461) in the U.S. among 45 healthy adults with mRNA 1273. This mRNA Coronavirus vaccine is known to target perfusion coronavirus Spike protein, mediating coronavirus membrane fusion and cellular attachment. This study is expected to complete by June 2021.
- CanSino Biologics along with Military Medical Science Academy of China on 17th March had launched trial of first phase (ChiCTR2000030906) in China using Ad5-nCoV among 108 healthy adults, volunteering for this project. This is considered to be recombinant vaccine that uses type 5 adenovirus vector. This study is expected to complete by December 2021.
- BioNTECH, a German biopharmaceutical company along with Pfizer in March 2020 had announced joint development of BNT162, considered to be an mRNA vaccine. By April 2020, trials are expected to take place.
- Janssen in February 2020, the subsidiary of the healthcare giant company Johnson & Johnson had teamed with BARDA (Biomedical Advanced Research & Development Authority) for funding Research & Development for Coronavirus drug program by using Janssen’s PER & AdVac non-replicating viral-vector technologies. Trials are expected to start by early November 2020.
Coronavirus treatment strategies
Even after the scientists put in herculean efforts, for the vaccine to become available commercially the world over, it is expected to take minimum 18 months timeframe. Companies are repurposing immune-inflammatory, anti-virals, anti-malarial drugs to identify therapies which can help alleviate symptoms arising from this virus. Few of the symptoms experienced by COVID-19 infected patients are fever, cough, fatigue, shortness of breath, myalgia (muscle pain). The Coronavirus drug to be developed is also expected to reduce disease associated complications like acute kidney failure, acute heart failure, (ARDS) acute respiratory distress-syndrome, pneumonia, lymphocytopenia, septic shock and rhabdomyolysis.
Clinical studies have shown that Chloroquinine and hydroxychloroquinine anti-malaria drugs that are generally available in the market do offer promising results. Teva Pharmaceutical Industries, Mylan, Bayer and Novartis, all have pledged to provide supplies to catch up with growing demands.
Mixed preliminary results have been witnessed with the usage of marketed anti-virals. HIV drug of AbbVie’s Kaletra (ritonavir/lopinavir) were found disappointing, when used for Coronavirus treatment. On the other hand Avigan (favipiravir), the wide spectrum based RNA polymerase inhibitor created by Zhejiang Hisun Pharmaceutical appeared to be more than effective to treat COVID-19 symptoms. US trials were initiated by Gilead Science’ with remdesivir (GS-5734), considered to be wide spectrum antiviral, developed originally to cure Ebola. It is found to have activity against the viral pathogens SARS & MERS.
Immune-inflammatory agents like Regeneron, Sanofi and Roche’s IL-6 (Interleukin-6) monoclonal antibodies Kevzara (sarilumab) and RoActemra/Actemra (tocilizumab) combined with growth factors with regards to development from Partner Therapeutics & Roviant are under clinical evaluation for treating respiratory sickness due to COVID-19.
Novel inhalation approach
‘Emergency expanded access’ is provided by the FDA to inhaled nitric-oxide delivery system Bellerophon Therapeutics’ for providing ventilation facilities to coronavirus patients. Safety trials have already been concocted by INOpulse among healthy volunteers, while new clinical trials are underway among COVID-19 patients, as well as for healthcare providers as preventative measures, in China. MHRA had recently given Synairgen, the UK biotech giant the green light to conduct 2nd phase trial in patients using its SNG001, inhaled interferon. Studies conducted this Coronavirus vaccine previously had reported it to be fit to be used to reduce lung pathology and lung viral load in viral pneumonia’s vivo swine-flu driven model.
