What if one day, we could swallow a simple tablet when we have the first symptoms of Covid-19?
If this fiction seems distant, several laboratories have developed treatments against the coronavirus.
As for monoclonal antibodies, Ronapreve is marketed in France, but it remains only indicated for patients who are at risk of serious Covid.
On the other hand, oral antivirals could revolutionize the management of Covid cases.
Useful, especially when dealing with Omicron.
What lab is working on it?
In what form ?
In what interest, and for when?
"20 Minutes" scrutinizes five anti-Covid treatments.
"To overcome this pandemic, you have to use a lot of tools and monoclonal antibodies are part of it," says Yazdan Yazdanpanah, infectious disease specialist and director of the National AIDS Research Agency (ANRS).
Today, we have effective, available treatments for which we have the data ”.
A little hope in this ocean of bad news on the Covid-19 front?
But what treatments are we talking about?
Who is working on it?
How effectively?
And for when?
20 Minutes
screened five anti-Covid treatments, available or in the process of becoming so.
RONAPREVE
Which laboratory?
This treatment, developed by the American biotech Regeneron and the Swiss laboratory Roche, combines two monoclonal antibodies (casirivimab and imdevimab).
In what form ?
It is administered via a single intravenous infusion, therefore in the hospital.
What is the point ?
"This treatment is designed to target the Spike protein, which allows infection," explains Alban Dhanani, deputy director of the Vaccines and anti-infectives Directorate of the National Medicines Safety Agency (ANSM).
These synthetic antibodies neutralize the protein in order to block the binding with the cells and thus prevent the virus from entering and multiplying in the cell.
"
And it is very effective: According to one study, only 0.9% of patients treated with Ronapreve were hospitalized or died, compared to 3.4% of patients who received placebo treatment.
Still, this treatment is very expensive: around 1,700 euros per dose, according to NGOs.
Is he available ?
It is the only treatment based on monoclonal antibodies currently available in France.
"This treatment was available in France eight months before the marketing authorization," notes Alban Dhanani.
It was authorized in March 2021 for immunocompromised people undergoing curative treatment.
While the marketing authorization from the European Medicines Agency dates from 11 November 2021. "
Today, this treatment can be prescribed as a curative in the first five days of the disease, when the patient has a mild form or has a severe form of the virus but has not yet intubated.
But also as a preventive measure, in the case of a patient at high risk, contact case, or for a patient who has not succeeded in developing antibodies after the vaccine.
Problem: this treatment remains underused.
This is why the health authorities and the ministry are working to facilitate access, in particular by making this monoclonal antibody treatment available in pharmacies.
EVUSHELD
Which laboratory?
AstraZeneca, which has also already developed a vaccine against Covid-19.
In what form ?
This treatment combines two types of monoclonal antibodies (tixagevimab and cilgavimab) and is given as two intramuscular injections, given immediately one after the other.
What is the point ?
It would be effective in protecting against the coronavirus even before exposure.
According to a study, this treatment reduces the risk of developing symptoms of Covid by 83%.
It would require "One injection every 6 months, which could greatly facilitate administration," greets Laurence Weiss, head of the Clinical Immunology Department at the European Hospital Georges-Pompidou (AP-HP).
These monoclonal antibodies do not replace vaccination in any way but protect immunocompromised patients or the rare people who cannot be vaccinated.
In addition, we can anticipate that the AstraZeneca cocktail should be effective on the Omicron variant, but that remains to be demonstrated.
"
Is he available ?
No, but it could be soon.
The European Medicines Agency (EMA) has been evaluating this cocktail of antibodies since October 14.
In addition, the American health authorities authorized last Wednesday the administration of Evusheld in certain individuals reacting badly to vaccines.
“It would be a very good prevention in immunocompromised, enthuses Alban Dhanani.
We expect a decision from the HAS soon.
"
LAGEVRIO
What lab?
This oral antiviral medicine, also called molnupiravir, has been developed by the Merck laboratory.
In what form ?
Orally, which is an advantage.
On the other hand, you must take this pill within five days after the first symptoms, twice a day for five days.
What is the point ?
"Easy to take: orally and for only five days", replies Alban Dhanani, from the ANSM.
However, the results of the clinical trial communicated on November 26 by Merck show a much lower efficacy than that announced in early October on the basis of intermediate data.
According to these results, the drug reduced by 30% (not by half, as initially announced) the rate of hospitalization and death in patients at risk who took it soon after the infection.
Other questions relate to the safety of this drug: in theory, its mode of action could favor the appearance of variants of the virus or cause carcinogenic effects.
These risks were, however, considered low by American experts.
Is he available ?
Not yet.
Lagevrio was approved in the EU for emergency use on November 19, 2021. “The marketing authorization application dates from November 23, 2021,” underlines Alban Dhanani.
We are expecting the final opinions very soon, ”from the European authority and the High Authority for Health for its marketing in France.
Olivier Véran announced on November 25 that France had ordered 50,000 doses of Lagevrio, which were due to arrive in early December.
A hot file, then.
PAXLOVID
What lab?
It was Pfizer who developed this treatment.
He uses two antivirals: PF-07321332 and ritonavir, already used against HIV.
The action is different: it does not mutate the virus, but the treatment blocks the replication of the virus.
In what form ?
It also comes in pill form, to be taken for five days, like molnupiravir.
What is the point ?
Its ease of access, since we avoid the hospital box.
But also its effectiveness.
Pfizer has announced promising results: an 89% reduction in hospitalizations and deaths, provided treatment is taken three days after the first symptoms.
Above all, Paxlovid and Lagevrio, cited above, do not target the Spike protein - where the mutations of the variants are concentrated -.
These two treatments should therefore remain effective against Omicron.
And facing the next variants.
Is he available ?
"For Paxlovid, we await the opinion of the EMA next week to use it in early treatment, continues Alban Dhanani of the ANSM.
The request for early access in France has been announced.
"
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