We've got the vaccine. Next up: the pill? That's what scientists are crossing their fingers on regarding COVID treatment, with at least three antiviral drugs in clinical trials that have the potential to be a "game changer," keeping the worst symptoms at bay in infected patients and shortening their infection time. Pfizer, Merck/Ridgeback Biotherapeutics, and Roche/Atea Pharmaceuticals all have options on the table, with Merck's molnupiravir right now the top contender, per Kaiser Health News.
- How the pills work: Basically, by stymieing the coronavirus' ability to reproduce in human cells. For molnupiravir in particular, "the enzyme that copies the viral genetic material is forced to make so many mistakes that the virus can't reproduce," Kaiser notes.
- New territory: Unlike remdesivir, so far the only antiviral drug given the OK for COVID treatment, these antivirals would be able to be administered during the early stages of the illness, before symptoms are bad enough to require hospitalization. These drugs would join the monoclonal antibody treatments that are currently available, which are usually given intravenously.
- How they'd be administered: If all goes as planned, treatment would come in the form of a daily single pill that's taken orally for five to 10 days after a COVID diagnosis.
- Timeline: "Within the next several months" is when Carl Dieffenbach, head of the Division of AIDS at the National Institute of Allergy and Infectious Diseases, sees results coming in from the clinical trials. Merck's CEO has said the company may be able to seek emergency-use authorization from the FDA by the end of the year.
- Challenges: Getting enough participants for the clinical trials, as well as rapid-enough distribution once the pills are available. Cost could also be an issue, with Merck paperwork implying a round of molnupiravir could run $700, per US News & World Report.
- Other players: Enanta Pharmaceuticals, Novartis, Pardes Biosciences, and Japan's Shionogi & Co. are also hard at work on antivirals for this purpose, though they're still in the early stages and at least a year behind the other three companies.
- Looking ahead: If success is found using antivirals in this way, researchers are hopeful on another use: that the drugs could be used to prevent COVID in those who've been exposed. "You could give it to everyone in a household, or everyone in a school," one of the doctors overseeing a molnupiravir clinical trial tells Kaiser. "Then we're talking about a return to, maybe, normal life."
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