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Drugs used for COVID-19 / Treatment of COVID-19 or Coronavirus disease as per the latest Guidelines
Remdesivir, Chloroquine/ hydroxychloroquine, Lopinavir/ritonavir and Tocilizumab for COVID-19
Remdesivir
Remdesivir is an investigational intravenous drug with broad antiviral activity that inhibits viral replication through premature termination of RNA transcription and has in-vitro activity against SARS-CoV-2 and in-vitro and in-vivo activity against related betacoronaviruses .
Blocks RNA-dependent polymerases
Several randomized trials are underway to evaluate the efficacy of remdesivir for moderate or severe COVID-19
Its clinical efficacy is not well understood.
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Hydroxychloroquine and chloroquine are oral prescription drugs that have been used for treatment of malaria and certain inflammatory conditions. Chloroquine has been used for malaria treatment and chemoprophylaxis, and hydroxychloroquine is used for treatment of rheumatoid arthritis, systemic lupus erythematosus and porphyria cutanea tarda. Both drugs have in-vitro activity against SARS-CoV, SARS-CoV-2, and other coronaviruses, with hydroxychloroquine having relatively higher potency against SARS-CoV-2
Both chloroquine and hydroxychloroquine have been reported to inhibit SARS-CoV-2 in vitro, although hydroxychloroquine appears to have more potent antiviral activity .
Use of chloroquine is included in treatment guidelines from China's National Health Commission and was reportedly associated with reduced progression of disease and decreased duration of symptoms . However, primary data supporting these claims have not been published .
Other published clinical data on either of these agents are limited. In an open-label study of 36 patients with COVID-19, use of hydroxychloroquine (200 mg three times per day for 10 days) was associated with a higher rate of undetectable SARS-CoV-2 RNA on nasopharyngeal specimens at day 6 compared with no specific treatment (70 versus 12.5 percent) . In this study, the use of azithromycin in combination with hydroxychloroquine appeared to have additional benefit, but there are methodologic concerns about the control groups for the study, and the biologic basis for using azithromycin in this setting is unclear.
Clinical trails explains that
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Treatment of Moderate to Severe Coronavirus Disease (COVID-19) in Hospitalized Patients
Estimated Study Completion Date : July 2021
• Lopinavir/ritonavir
• Hydroxychloroquine sulfate
• Baricitinib (janus kinase inhibitor)
• Sarilumab (anti-IL-6 receptor)
Tocilizumab – Treatment guidelines from China's National Health Commission include the IL-6 inhibitor tocilizumab for patients with severe COVID-19 and elevated IL-6 levels; the agent is being evaluated in a clinical trial
Tocilizumab is under investigation for COVID-19 Pneumonia - Drug: Tocilizumab Injection , present in Phase 2 clinical trials
Inhibition of IL-6 receptors by tocilizumab leads to a reduction in cytokine and acute phase reactant
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Lopinavir-ritonavir – Lopinavir-ritonavir appears to have little to no role in the treatment of SARS-CoV-2 infection. This combined protease inhibitor, which has primarily been used for HIV infection, has in vitro activity against the SARS-CoV and appears to have some activity against MERS-CoV in animal studies . However, there was no difference in time to clinical improvement or mortality at 28 days in a randomized trial of 199 patients with severe COVID-19 given lopinavir-ritonavir (400/100 mg) twice daily for 14 days in addition to standard care versus those who received standard of care alone
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The expanded access program for the United States is under rapid development. Further information is available at: [ Ссылка ] icon
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