Will the year 2022 be quieter than the previous one from a health point of view? “This fifth wave will perhaps be the last”, wants in any case to believe the Minister of Health Olivier Véran, as he confided on Sunday to JDD. If nothing is less certain, there are reasons for hope. And among them, the treatments against Covid-19 which are developing and starting to be distributed in some countries.
This is the case in Israel, already a pioneer in vaccination against the SARS-CoV-2 virus. The country has already received its first shipment of anti-Covid pills from Pfizer, authorized last week by the United States Medicines Agency (FDA), which also cleared the pill from the Merck laboratory. These two treatments with different properties help to fight against the development of severe symptoms of the disease in infected people.
The hope of paxlovid
The first, called paxlovid, and developed by the Pfizer laboratory, reduces hospitalizations and deaths in at-risk people by 88% when taken within the first five days after symptoms appear, according to clinical trials focused on more than 2,200 people.
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“This is a key element, along with the vaccine and the mask, in the strategy to stem the Omicron wave,” epidemiologist Ran Balicer, head of innovation at the fund, told AFP. Israeli health insurance Clalit. According to him, Pfizer’s treatment could save people most at risk of developing severe symptoms linked to the virus. “For these people, this drug could dramatically reduce the risks if the infection is detected quickly, which will also reduce the pressure on hospitals,” said this expert.
The Pfizer pill is a combination of two pills, taken twice a day for five days. This pill may be given to high risk patients aged 12 years and over.
The less effective Merck pill
That of Merck raises more reservations. Intended for high-risk adults, the treatment called molnupiravir was urgently authorized by the United States Medicines Agency (FDA), the day after the authorization granted to Pfizer. “Today’s authorization adds a new treatment for Covid-19, in the form of a pill that can be taken orally,” said FDA official Patrizia Cavazzoni. It has already been licensed in the UK and Denmark.
The medically developed by Merck can also be taken within five days of the onset of symptoms, and is administered at eight doses per day for five days. It works by entering the genome of the virus to cause mutations that limit its reproduction. The most common side effects were taste disturbance, diarrhea and nausea.
Molnupiravir reduces the risk of hospitalization and death by 30% among the frail population, according to clinical trials conducted on 1,400 participants. Preliminary results, which only took into account a portion of the trial participants, initially suggested a 50% reduction in the rate of hospitalization and death in patients at risk.
Although vaccination remains the main tool in the fight against the pandemic, experts welcome the arrival of new oral treatments which should, in time, be easily accessible in pharmacies, on presentation of a prescription. Anti-Covid treatments previously available, such as monoclonal antibodies or Gilead’s remdesivir, are administered intravenously.
Waiting on the European market
Antivirals work by reducing the ability of a virus to replicate, thereby slowing down the disease. They are eagerly awaited because they are easy to administer and can be taken at home with a glass of water. In the European Union, the use of pills is currently only authorized in emergencies by the European Medicines Agency (EMA).
Paxlovid “which is not yet authorized in the EU can be used to treat adults with Covid-19 who do not need supplemental oxygen and who are at increased risk of developing a severe form of the disease. disease, “said the agency in mid-December, which also launched an accelerated review of the treatment with a view to a possible application for marketing authorization.
The limits of these treatments
Drugs from Pfizer and Merck, which do not target the constantly changing virus Spike protein, should be more resistant to newer variants like Omicron. According to the two companies, preliminary laboratory results support this hypothesis.
However, these are not miracle pills. In its clearance document, the FDA stresses that the Merck pill should only be administered if other options are not available or not recommended. The Pfizer pill, on the other hand, does not go well with some treatments and is not recommended for patients with severe kidney or liver failure.
While clinical trials have not detected any major risks to patients for the two drugs, Merck’s is causing more concern. The US Medicines Agency has not cleared it for those under the age of 18 because it could affect bone and cartilage development. It is also not recommended for pregnant women, due to potential risk to the fetus, but doctors may ignore it if the benefits outweigh the risks.
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Another question arises: will there be enough pills for everyone? The United States has already purchased 3.1 million treatments from Merck and 10 million from Pfizer. Merck announced to AFP to be able to deliver “hundreds of thousands” in the coming days and three million by the end of January. Not enough, for the moment, to heal the planet.
