Molnupiravir reduced the risk of hospitalization by 50% in those with COVID-19, according to clinical trials.
What is Molnupiravir?
This is a medicine that was developed at the universityEmory in the USA. The research was carried out by the pharmaceutical company Drug Innovation Ventures at Emory (DRIVE). Initially, they wanted to use molnupiravir only to fight the flu: the drug has shown itself to be successful.
In April 2020, molnupiravir was decidedtested to combat SARS-CoV-2, as well as other coronaviruses: MERS-CoV and SARS-CoV. Scientists used infected mice for the experiment: as a result, the rodents' lung function improved and weight loss decreased. All this indicates that the drug has an antiviral effect.
At the end of 2020, the effectiveness of molnupiravirtested on ferrets that were infected only with SARS-CoV-2. The animals were administered the drug orally every day: this process helped reduce the viral load that was in the upper respiratory tract. In addition, molnupiravir helped block the transmission of the virus among the entire animal population within 24 hours after administration.
How does molnupiravir work?
In short, the active substance from the drug is integrated into the genome of the virus and introduces mutations there to stop the life cycle.
Detailed mechanism of action of molnupiravir, whichdescribed in a scientific journal, it looks like this. The genome of the new type of coronavirus is an RNA molecule. After the virus enters the body, it begins to multiply: new molecules are created using ribonucleotides - A, G, C and U.
After taking molnupiravir, the drug penetrates intoRNA molecules, which are obtained as a result of replication, in the form of one of the nucleotides. And already during the next reproduction, a phenomenon occurs, which is called tautomerism - this is when a molecule is in the form of two isomers in a certain equilibrium. As a result, mutations appear in the virus. With each breeding cycle, they begin to accumulate.
The review also notes that the drug does not attract the attention of the virus’s defense systems and all mutations, up to a certain point, occur unnoticed.
As a result, the virus genome accumulates many random mutations that seriously change it, and it stops working as before, for example, it stops reproducing or building a viral envelope.
What is known about the effectiveness of the new drug?
Molnupiravir was tested among 170 patientsdifferent countries, among them was Russia. The researchers recruited unvaccinated patients who had to prove they had less than five days of mild or moderate illness with COVID-19 and had at least one risk factor for adverse illness, such as diabetes or obesity.
The authors studied 762 volunteers formonth. In the group where patients were given placebo, 53 people, or 14.1% of the total, were hospitalized and eight died. A total of 377 patients were given placebo. And in the group that was given molnupiravir, only 28 volunteers were hospitalized—that’s 7.3% of 385 people. No one from the group died.
As a result, the researchers concluded that molnupiravir reduced the likelihood of severe COVID-19 by almost half.
Also, 40% of the volunteers who participated instudy, they sequenced the virus to understand which strain a person is sick with, and to compare the effectiveness of molnupiravir in this regard as well. As a result, it became known that the drug worked equally against all detected variants of the new type of coronavirus. In particular, it dealt with gamma, delta and mu strains with 80% efficiency.
It was noted that molnupiravir was effective iftake it immediately after the onset of the disease. If the person was already hospitalized, then the use of the medicine did not lead to serious progress and improvement of the condition.
When will deliveries to other countries start?
Now the manufacturing company Merck & Cointends to obtain an emergency use license for molnupiravir in the United States, and is also collecting documents and information to apply for registration of the drug in several countries. It is not specified which specific countries we are talking about.
Although clinical trials have notcompleted, the company is already producing drugs and plans to produce 10 million courses of therapy by the end of 2021. Earlier it became known that the US government ordered 1.7 million courses of molnupiravir for $1.2 billion.
Can molnupiravir be used instead of the vaccine?
It’s impossible to say for sure yet.During the trial, molnupiravir was given to patients who had not been vaccinated, so it is unclear whether a vaccinated person who has recently become infected should take the drug.
Molnupiravir has not yet been certified, butThe results of testing the drug have already been published in several scientific papers in authoritative international journals: Nature, Science Translational Medicine and Nature Structural & Molecular Biology.
This suggests that the drug with a large proportionprobabilities are certified at least in the United States and will be used, for example, at home to help the body speed up treatment and reduce the risk of COVID-19 becoming severe.