01 January 2022: Editorial
Editorial: Current Status of Oral Antiviral Drug Treatments for SARS-CoV-2 Infection in Non-Hospitalized PatientsDinah V. Parums
Med Sci Monit 2022; 28:e935952
ABSTRACT: On 4th November 2021, the first oral antiviral drug for COVID-19, molnupiravir (Lagevrio®), received full regulatory approval from the Medicines and Healthcare Products Regulatory Agency (MHRA) in the UK. Molnupiravir is an orally bioavailable antiviral drug for use at home when a SARS-CoV-2 test is positive. On 22nd December 2022, the FDA granted emergency use authorization (EUA) for the oral antiviral drug, nirmatrelvir/ritonavir (Paxlovid®) for adults and children with mild and moderate COVID-19 at increased risk of progression to severe COVID-19. These regulatory drug approvals come at a crucial time when new variants of concern of the SARS-CoV-2 virus are spreading rapidly. Although the FDA approved remdesivir (Veklury®) on 22nd October 2020 for use in adults and children for the treatment of COVID-19 requiring hospitalization, its use has been limited by the requirement for intravenous administration in a healthcare facility. The four FDA-approved therapeutic neutralizing monoclonal antibodies, imdevimab, bamlanivimab, etesevimab, and casirivimab are costly and also require medically-supervised intravenous administration. The availability of effective, low-cost oral antiviral drugs available in a community setting that can be used at an early stage of SARS-CoV-2 infection is now a priority in controlling COVID-19. An increasing number of repurposed antiviral drugs are currently under investigation or in the early stages of regulatory approval. This Editorial aims to present an update on the current status of orally bioavailable antiviral drug treatments for SARS-CoV-2 infection.
Keywords: Editorial, molnupiravir, Ritonavir, severe acute respiratory syndrome coronavirus 2, COVID-19
Two years on from the start of the COVID-19 pandemic, it is clear that not only is the SARS-CoV-2 virus now an endemic pathogen, but it can rapidly mutate and develop new variants that may evade the immune response generated by current vaccines. The increasing burden on hospitals and healthcare systems is not sustainable and more control of SARS-CoV-2 infection is required at the community level, with early treatment from home. Full regulatory authorization of the orally bioavailable and repurposed oral antiviral drug, molnupiravir, and the recent FDA EUA of nirmatrelvir/ritonavir, herald the era of early treatment of SARS-CoV-2 infection to prevent severe COVID-19 and reduce hospital admissions.
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