In parallel to vaccine development, doctors around the world are testing whether existing drugs can also help against SARS-CoV-2. This saves valuable time and can save lives.
Perhaps there is no need to find a new drug against the new SARS CoV-2 coronavirus. Existing active substances may also help against the COVID-19 pathogen.
The advantage of the process called “repurposing” is obvious, because repurposing already approved or developed drugs is not only cheaper, but above all much faster, because the lengthy clinical test phases can be shortened.
At least 68 vaccine projects have started worldwide , but even if a suitable vaccine is found in 2020, the German pharmaceutical association VfA considers mass vaccinations unlikely even this year in Germany. Therefore, the only alternative is either further months of isolation or treatment with existing or developed active ingredients.
Whichever active ingredient or medication is ultimately most sensibly used against the new coronavirus: First, the necessary tests and decisions by the drug authorities have to be awaited.
All experts strongly warn of possible side effects, especially with self-medication without consulting a doctor!
So please wait and not just swallow any medication out of fear!
Three different drug groups
Currently, three groups of drugs are being tested for their effectiveness against the new coronavirus SARS-CoV-2:
Antiviral drugs are designed to block the multiplication of viruses or prevent them from entering lung cells. Antiviral drugs have been developed, for example, against normal influenza flu, against hepatitis C, but also against HIV, Ebola and, above all, against the two diseases SARS or MERS, which are also caused by coronaviruses. Well-known malaria drugs, whose effectiveness against viruses have only recently been discovered, are also being tested.
Immunomodulators are supposed to limit the body’s defense reactions in such a way that the immune system does not overreact and additionally damage the body in a life-threatening manner. These immunomodulators were developed, for example, for the treatment of arthritis or inflammatory bowel diseases.
Medications to protect the lungs are to prevent the lungs from supplying the blood with insufficient oxygen. The drugs were developed, for example, against the often fatal idiopathic pulmonary fibrosis, in which the pathological increase in connective tissue between the alveoli and the surrounding blood vessels leads to stiffening of the lungs. Breathing becomes superficial and quick. Shortness of breath and dry cough are the consequences.
Active substances against SARS, MERS, Ebola, influenza
It is natural to dedicate antiviral drugs that have already worked against other coronaviruses. Finally, both Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS) are caused by coronaviruses. And the new pathogen SARS-CoV-2 is considered a variant of the SARS pathogen from 2002.
In the laboratory, the active ingredient remdesivir , which was originally developed against Ebola infections, also had an effect on SARS and MERS coronaviruses. However, the remdesivir developed by the US pharmaceutical company Gilead Sciences has not yet been officially approved in any country worldwide. Clinical trials with remdesivir are currently ongoing in the United States and China.
The Japanese flu drug Avigan , which contains the active ingredient favilavir, which has been approved in Japan since 2014 and now also in China, is causing real hype worldwide . It was developed by the pharmaceutical division of Fujifilm Holding in Japan. This antiviral is actually used against influenza because it inhibits viral RNA polymerase and how remdesivir is supposed to work against various RNA viruses.
In 2014 it was successfully used against Ebola. In 2016, the Japanese government delivered favipiravir to Guinea as an emergency aid to combat the Ebola disease. According to the Chinese government, promising clinical studies with Avigan are also available from the Chinese city of Wuhan, the epicenter of the novel coronavirus.
Thereupon there was only a real rush for Avigan in Asia and now worldwide, which the German virologist Christian Drosten of the Berlin Charité described as “promising” after a few tests in Italy. As a precaution, Japan has stashed two million parcels of Avigan. Other countries such as Indonesia with around 270 million inhabitants, but probably also Germany, have already ordered millions of tablet packs, although the actual tests are far from over.
Active substances against malaria
The well-known malaria drug Resochin has also caused a lot of excitement in recent weeks . Its active ingredient chloroquine was previously used as malaria prophylaxis. In recent years, however, it has rarely been prescribed. In tests in Marseille, the active ingredient chloroquine on cell cultures is said to have inhibited the multiplication of the novel coronavirus, thereby reducing the viral load of the patients in the event of more severe illnesses. The drug can therefore also be used antivirally, the doctors report.
So far, however, Bayer’s Resochin drug, developed in the 1930s, has only been manufactured at one location in Pakistan. The German pharmaceutical and chemical group now wants to create production options for the active ingredient chloroquine in Europe as quickly as possible and donate the drug to governments free of charge. The German health minister Jens Spahn has already reserved “large amounts” of the drug.
Other malaria drugs with the similar active ingredient hydroxychloroquine are currently being tested . Novartis and Sanofi also plan to make millions of doses available to treat people around the world if the drug authorities are positive .
However, virologists like Christian Drosten from the Charité in Berlin have expressed concerns about the conduct and significance of the study in Marseille.
The United States Department of Health and Social Services also raised concerns after US President Donald Trump spoke out about the use of chloroquine in the treatment of COVID-19 sufferers.
Active substances against HIV, cancer, multiple sclerosis, asthma etc.
There are also high hopes for an HIV drug with the active ingredient combination lopinavir / ritonavir . The corresponding drug Kaletra from the US pharmaceutical company AbbVie has already been used in China, Thailand and Singapore on a trial basis as a COVID-19 therapeutic. However, the results are not clear, further studies have to follow.
According to the Association of Research-Based Pharmaceutical Companies, various antibodies and immunotherapeutics are also being tested for their effectiveness against the new corona virus. The previously approved or experimental drugs include the anti-HIV and triple-negative breast cancer antibody Leronlimab by CytoDyn, two anti-MERS antibodies originally developed by Regeneron and the active ingredient brilacidin by Innovation Pharmaceuticals, which was originally intended for the treatment of inflammatory bowel diseases and inflammation of the oral mucosa was.
In addition, there are a large number of active substances that are currently being developed or that have already been approved, for example against influenza, multiple sclerosis (MS), breast cancer, arthritis, asthma, inflammation of the pancreas or hepatitis. They are now also being tested for effectiveness against SARS-CoV-2.
In China, for example, Novartis’ fingolimod MS drug and bevacizumab cancer drug are used in COVID-19 patients with acute lung problems. The Roche tocilizumab antibody , which is normally used in rheumatoid arthritis and other forms of arthritis, is also said to help with lung damage caused by the SARS CoV-2 pathogen .
A German consortium under the leadership of the German Primate Center in Göttingen is also planning clinical studies with the active ingredient Camostat Mesilat . This active substance, which is approved in Japan for inflammation of the pancreas, inhibits an enzyme from lung cells which is essential for the penetration of the SARS-CoV-2 viruses.
Joint fight against SARS-CoV-2
In order to clarify the suitability of existing drugs as quickly as possible, the European Medicines Agency (EMA) has appealed to companies and research institutions to conduct joint, multinational, coordinated patient studies for their drugs.
The World Health Organization (WHO) has also recently announced a large-scale study : this study, called SOLIDARITY, is intended to test four drugs in several countries for their effectiveness against the new coronavirus. Despite all the competition, numerous leading pharmaceutical companies have come together to develop new therapeutic drugs (such as vaccines and diagnostics) against COVID-19. In a first step, they want to make their own collections of molecules available, for which some data on safety and mode of action are already available. For molecules classified as promising, animal experiments should also begin within two months.