Antivirals, unlike monoclonal antibodies, should be effective against all variants. Anelli (Fnomceo): “Organizational problems in the prescription process”
With over two and a half million positives (of which 99.2% in home isolation), the risk of a slowdown in the country’s essential activities is strong. Omicron, according to the latest data from the Higher Institute of Health, is 80% widespread: it is therefore clear that it is the new variant that supports the growth of infections. Are there any drugs that could accelerate the healing of the infected?
In two years of the pandemic, great strides have been made on therapies, both for severe forms and for the initial infection. Specifically against Sars-CoV-2 monoclonal and antiviral antibodies have been developed. These are drugs to be administered at the beginning of the infection, immediately after the onset of symptoms, so they could substantially reduce the duration of positivity (and consequently the number of infections). “The monoclonal antibodies were built on variants previous to Omicron, some have shown some efficacy against Delta, but they are drugs sensitive to the surface proteins of the virus that change significantly when a new strain appears – he explains. Gianni Sava, professor at the University of Trieste and member of the Italian Society of Pharmacology (Sif) -. So the doubt is that they may not be effective against Omicron, also because, unlike vaccines, it is not easy to produce updated versions ». Greater hopes focus on sotrovimab, a monoclonal antibody developed by GlaxoSmithKline and Vir Biotechnology, recommended by the World Health Organization in recent days as a cure against moderate and severe Covid (along with baricitinib, an anti-inflammatory used to treat rheumatoid arthritis) and cleared for trade in Europe on December 17. Sotrovimab binds to a portion of the coronavirus Spike protein that remains essentially unchanged.
What are the benefits of antivirals?
These drugs, to be taken by mouth (while the monoclonal antibodies are administered intravenously) lower the viral load, preventing the infection from degenerating into disease. «Technically, the antivirals are not dependent on the mutations of the variants, because they act on the mechanisms of multiplication of the virus – emphasizes Sava -. Compared to monoclonals they have the advantage, being small molecules, of being able to enter our cells ».
In addition to the pill produced by Merck, already available in Italy, that of Pfizer will also arrive. Who can actually take advantage of these medicines?
Lagevrio (Merck) and Paxlovid (Pfizer) are intended for outpatient adult patients with recent onset mild to moderate disease and risk factors for severe Covid. “However, there is an organizational problem – he says Filippo Anelli, president of the National Federation of Orders of Surgeons and Dentists (Fnomceo) -: general practitioners select candidate patients to receive therapy, but then a specialist’s go-ahead is needed and the product is dispensed from hospital pharmacies. A chain that risks, between the outcome of the tampon and the arrival of the pills at the patient’s home, of exceeding the famous 5 days within which the antivirals are effective ».
Does the ministerial protocol on home care remain valid for paucisymptomatic patients?
Yes, the drugs indicated are paracetamol and NSAIDs (non-steroidal anti-inflammatory drugs), but it is essential to follow the instructions of your doctor. “The high-dose aspirin does not give any risk of bleeding, unlike the aspirinetta – explains Sava -. However, it cannot be used in children due to a rare serious side effect, Reye’s syndrome. Be careful not to overdo it with paracetamol, which in high doses is toxic to the liver. Finally, cortisone, if taken too early, can weaken the immune system and mask the severity of the infection “.
January 17, 2022 (change January 17, 2022 | 23:08)
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