The approval of Paxlovid for use in the UK adds a new weapon to the arsenal of treatments for Covid-19. If taken soon after an illness occurs, the drug can prevent severe illness in vulnerable adults. Paxlovid is one of the newer antiviral medicines that can be given to people who have contracted the disease. The hope that vulnerable individuals, including the elderly and those with compromised immune systems, can be kept out of hospital is provided by the use of antivirals.
It took two years of research for the first antivirals to be approved, with drugs becoming available more than a year after the first Covid vaccines were given in the UK. Why has it taken so long for effective antivirals to be developed? What role will they play in the UK?
When most predictions were correct, vaccines and antivirals came first. Why?
Tom says he expected antivirals to be used before vaccines. The failure of the first wave of antivirals that were tested reflects the incredible speed of vaccine research.
At the start of the epidemic, most of the effort was made to consider drugs that were used to treat other illnesses but which had established safety profiles.
The UK Agile trial is trying to find new Covid treatments, and none of the repurpose antivirals have worked. Scientists focused on new antivirals specifically designed for Covid-19 after that. Drug development takes five to 10 years. The timelines have been accelerated but it has taken two years to get to this point.
How will the new drugs be used?
Doctors know a lot about treating Covid-19 patients. The chair of the BioIndustry Association said that they have greatly improved the outcomes for seriously ill patients. Prevention is better than cure. The goal is to keep people out of hospital, and the new oral antivirals should help achieve that.
If a vulnerable person becomes sick, they will be given Paxlovid or Molnurpiravir, which will prevent them from going to the hospital, which is good news for the patient.
What needs to be discovered about the drug?
Eddie Gray, chair of the UK government's antivirals taskforce, said that clinical trials of antivirals began shortly after Covid first arrived. We have a population that is largely vaccine free. We need to show that the benefits of antivirals are still there.
The data will be provided by the Oxford University study called Panoramic, which is assessing the impact of antivirals on vulnerable but vaccine-free people in the UK. Gray said that phlegm is very important. The mechanism by which we will work out the magnitude of the benefit our population gets from antivirals is the one we will use. We expect results next month.
What lessons can be learned from treating Covid with other drugs?
The drugs disrupt the way that a virus produces copies of itself inside our cells and we have seen this process being used in antivirals that deal with other diseases. One implication is that they are likely to be very effective in tackling new variant of Covid.
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