The covid-19 pandemic has not only triggered intensive development of vaccines and new drugs, but has also supported research into existing drugs that could help fight coronavirus infection. Intensive clinical trials of older drugs in the new SARS-CoV-2 indication are currently underway, which could alleviate symptoms and facilitate the course of covid-19 disease. Innovative medicines are also coming into play that have not yet been registered but have yielded promising results in clinical trials. The Ministry of Health of the Czech Republic has temporarily approved two unregistered drugs for the treatment of covid-19 for emergent use (these are products of Eli Lilly and Regeneron Pharmaceuticals in cooperation with Roche).

Many pharmaceutical companies equipped with knowledge of previous viral epidemics (eg SARS, MERS, influenza, HIV), together with academia and SMEs, are looking for effective tools to combat SARS-CoV-2 (eg ACE inhibitors, protease inhibitors or immunotherapeutic methods). A number of drugs have been tested that have shown promising effects in the treatment of covid-19 in studies reviewed in medical articles to date. Most of them are undergoing further clinical trials. 

Innovative drugs used in connection with covid-19

• The first group of drugs prevents the virus from multiplying in the infected organism. Some of them are taken orally and should be used in the early stages of the disease. Clinical studies are currently underway, the results of which should be known in the first quarter of this year.
• Another group are monoclonal antibodies, or proteins that prevent the virus from entering human cells, which bind to and inactivate SARS-CoV-2. The results of clinical studies are already known here, on the basis of which the Ministry of Health of the Czech Republic recommended their use in February, and has already temporarily approved the first unregistered anti-covid-19 drugs for emergent use in patients with severe conditions.
• The third group are drugs that suppress the inflammatory response caused by a viral infection. Some are already used to treat rheumatoid arthritis. This group includes anti-interleukin-6 antibodies, for which the results of clinical studies are not yet clear, but also drugs acting on multiple inflammatory mediators, such as the Janus kinase inhibitor. The possible use in patients with covid-19 is decided exclusively by the attending physician. Drugs that modulate the immune response are similar.

How drugs are evolving

Research and development of drugs against covid-19 is another way of fighting the innovative pharmaceutical industry with the current pandemic. It is subject to the same internationally valid clinical trial rules as other medicinal products. The development of a completely new drug usually takes many years and costs up to two billion US dollars. In the case of SARS-CoV-2, it is often used with already existing medicinal products registered for another indication (products registered in other indications) or with molecules already developed.

Taken from Apatyka servis, 9. 3. 2021, PharmDr. Michal Janů, Ph.D., PharmDr. Bohdana Švehlová