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A new combination of drugs may help treat COVID-19

Someone wearing a fact mask holding boxes of remdezivirShare on Pinterest
A recent study tested combinations of drugs to treat COVID-19. Himanshu Vyas / Hindustan Times via Getty Images
  • Although vaccines are now available for most of the world, more successful treatment of COVID-19 is still needed.
  • Researchers believe that a combination of FDA-approved antiviral drugs may help people with SARS-CoV-2 infections.
  • They combined the drug remdezivir, which is effective against Ebola, with drugs that can treat hepatitis C.

As the incidence of COVID-19 worldwide increases again, the race to find an effective treatment for the disease continues.

Researchers at Mount Sinai Hospital in New York, New York, believe that a combination of drugs already approved for use in the United States may be the key to treating COVID-19.

The researchers combined remdezivir, which doctors already prescribe to hospitalized patients with COVID-19, with various drugs for the hepatitis C virus (HCV). They hoped to identify a combination that slowed viral replication.

“Here we see a promising interaction that, if confirmed by further research and clinical trials, could provide a new antiviral drug to combat COVID-19,” said Dr. Gaetano Montelione, a professor at the Rensselaer Polytechnic Institute in Troy, New York.

Since the World Health Organization (WHO) declared the new coronavirus a pandemic in March 2020, nearly 150 million people have been infected with the virus and approximately 3 million have died.

Over the past year, researchers have studied a number of drugs and therapies that help treat COVID-19.

Remdezivir, for example, can treat COVID-19 in an inpatient setting. According to one article, remdezivir may “target specific viral enzymes or attack a weak site of viral replication in the host.”

Some corticosteroids, such as dexamethasone, may reduce inflammation in people with COVID-19.

Researchers are also considering the use of hydroxychloroquine to treat COVID-19. Doctors use hydroxychloroquine to treat malaria and rheumatoid arthritis, but further research has shown that it is more harm than good in people with COVID-19.

The authors of a recent article that appears as preliminary evidence in the journal Cellular reports, looked at 10 different HCV medicines in their study. Their goal was to find something that potentiates the effects of remdezivir in people with COVID-19.

The research team believes that HCV drugs can bind to an enzyme called Mpro. This enzyme is the major protease of SARS-CoV-2, which is essential for viral replication.

The team tested HCV drugs in monkey and human cells. They found that 7 of the 10 drugs could act as an inhibitor of SARS-CoV-2.

Although seven drugs are effective in inhibiting virus replication, additional experiments show that four of them inhibit a different protease called PLpro.

The four drugs that were effective in increasing the benefits of remdezivir were paritaprevir, grazoprevir, simeprevir and vaniprevir.

These drugs are synergized with remdezivir. This means that they have increased the effectiveness of remdezivir in reducing viral replication by “up to 10 times”.

“The combined use of remdesivir with PLpro inhibitors for the treatment of COVID-19 may alter the [people] with COVID-19 that have not been vaccinated, ”said study author Dr. Adolfo Garcia-Sastre.

Dr. Chris White, an assistant professor of microbiology at Icahn Mount Sinai in New York City, New York, believes the new study could “produce a highly effective antiviral cocktail.”

Chris Coleman, an assistant professor of infectious immunology at the University of Nottingham, UK, told Medical news today that this study has “many positive aspects”.

“Targeting two steps of viral replication means you’ve hit the virus twice, making the virus less likely to mutate to avoid treatment,” he explained.

Although the combination has great potential, researchers say there is one major hurdle to overcome: Remdezivir is not an oral drug. People receive it intravenously in a hospital setting, so the doctor will not be able to simply write a prescription and send a person home for treatment.

Remdezivir injection may take from 30 minutes to 2 hours. In addition, people usually receive it daily and treatment can last 5-10 days.

The use of the drug only in a hospital setting creates a number of problems. Not only would it be less than ideal for people who are ill to travel for treatment, but it would also be less accessible due to cost and travel constraints.

“Our goal is to develop a combination of oral medications that can be given to outpatients before they are ill enough to require hospitalization,” said study co-author Dr. Robert M. Krug.

Dr Jonathan Stoye, a virologist at the Francis Creek Institute in London, UK, told MNT that he finds the results promising, but that more work is needed.

“This interesting study seeks to identify new strategies for the treatment of COVID-19, using combinations of FDA-approved, reassigned drugs originally developed against other viruses,” said Dr. Stoye.

“This clearly shows that drugs targeting HCV protease in combination [with] remdezivir show a synergistic inhibition of SARS-CoV-2 replication. “

“However, although these results are promising, they seem quite preliminary, as the mechanism by which drugs do not synergize has not been established. In particular, the true purpose (s) of protease inhibitors remain poorly defined. “

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