Filenews 29 January 2022 - by Marilena Panagi
The number of drugs and treatments available to doctors around the world to treat the symptoms caused by COVID-19 is growing. However, and despite the fact that eight different formulations are now officially available at European level, both the European Medicines Agency (EMA) and scientists stress that these are not addressed to all people suffering from coronavirus and cannot be administered to all patients, since they hide the risk of side effects or conflict (as in the case of the new pharmaceutical formulation approved the day before yesterday by the EMA) with other treatments that may be available. It is also important to point out that no pharmaceutical preparation works preventively, since their administration is only done when the person is infected with the virus and becomes ill.
The drug "Paxlovid" (Pfizer), is the first oral formulation to be licensed by the European Medicines Agency after the first formulation made available to doctors, "Molnupiravir" (Merc), was made available under a special provision for pandemic and emergency situations. Both of these preparations are administered orally and are addressed both to patients who are not hospitalized and to patients admitted for treatment to hospitals. "Molnupiravir" has been administered in recent weeks to Cypriot patients, while "Paxlovid", which received permission the day before yesterday from the EMA, is expected to arrive in Cyprus at the end of February.
The remaining six treatments available to doctors are "monoclonal antibodies". As the Associate Professor of Pharmacology Christos Petrou explained to "F", "they are either new monoclonal antibodies, or monoclonal antibodies that are also used for other purposes and have now been included in the protocols for the treatment of a specific stage of the COVID-19 disease". These formulations, however, he stressed, "are only for inpatient use and aim to treat the multi-inflammatory syndrome caused by the disease" and "our doctors in Cyprus, depending on the assessments and needs of their patients, have at their disposal tools to deal with the cases before them". At the same time, he recalled that "the first drug approved was Remdesivir which is also an antiviral drug, but is used intravenously".
For the formulation "Paxlovid", of the company Pfizer, Mr. Petrou explained that it is a treatment that consists of a combination of two antiviral drugs: A new antiviral of "PF-07321332" and "Ritonavir", an older antiviral drug. "PF-07321332", "acts by reducing the ability of the virus to multiply in the body, while the low dose of "ritonavir", prolongs the action of "PF-07321332" by slowing down its breakdown and allowing it to remain longer in the body at levels that affect the multiplication of the virus for a longer period of time".
It is taken orally, "there are two tablets of different colour and each of them contains each active substance".
"Paxlovid", he stressed, "is indicated for the treatment of COVID-19 in adults who do not require supplemental oxygen and who are at increased risk of progression to a severe form of COVID-19", while "studies have shown that treatment with 'Paxlovid', significantly reduced hospitalizations or deaths in patients who had at least one underlying disease and had a risk of becoming seriously ill from COVID-19 and being hospitalized." "It is important that most of the patients who participated in the study were infected with the 'Delta' variant," Mr. Petrou added.
"Paxlovid", "should be administered as soon as possible after the diagnosis of COVID-19 and within five days of the onset of symptoms. It is recommended to complete the full five-day treatment cycle even if the patient requires hospitalization due to severe or critical COVID-19 after starting treatment with "Paxlovid".
Specific warnings include: "For patients with renal insufficiency, this is why the dose is adjusted in these patients, and great care should be taken in interactions with other medicines. It is subject to many restrictions in terms of its indications, and is not suitable for anyone infected with the coronavirus."
"It is not a drug that has a preventive effect and does not replace vaccination, on the contrary it can be complementary to specific groups of patients where there is no high effectiveness of the vaccine," Mr. Petrou concluded.
In Cyprus at the end of February
The formulation "Paxlovid", as the Deputy Director of Pharmaceutical Services Elena Panagiotopoulou said while talking to "F", "is expected to be in Cyprus, possibly in the 3rd or 4th week of February", pointing out that "as soon as it is secured in Europe it will be automatically in Cyprus". According to Mrs. Panayotopoulos, "in Cyprus it is expected that we will have a quantity to cover more than 15,000 patients". She added that "this drug has excellent results, however, there are also many contraindications, since there are many interactions in combination with other drugs and this pill cannot be given, among other things, to pregnant and nursing mothers."
Like "Molnupiravir", "Paxlovid", as Mrs Panayotopoulos said, "will be prescribed by personal doctors and other specialties, through the HIO system and citizens will obtain it only from hospital pharmacies". At this time, she added, "a special committee has been set up to prepare the protocol on the basis of which the formulation will be administered, and will guide doctors in relation to the prescription and what to look out for in this process." Regarding the formulation "Molnupiravir", the Deputy Director of pharmaceutical services stated that "to date, 125 treatments with Molnupiravir have been given since the day of its release and no reports of unwanted side effects have been observed so far. For the Novavax vaccine, Ms. Panayotopoulos said that "it is expected to be in Cyprus, as in the rest of Europe, at the end of February".
