Tosi mielenkiintoinen artikkeli SA:ssa koskien remdesiviriä ja muutamia muita, kuten tänään maikkarin mainostavaa hydroksiklorokiinia. Maikkarilla painostettiin Fimean johtajaa melkein kuin amerikkalaisessa rikosoikeudenkäynnissä. Eija Pelkonen sanoi moneen kertaan, että monia lääkkeitä tutkitaan ja mitään ei ole vielä hyväksytty. Aamun haastattelu ja sitä seuraavat uutiset olivat vähän kyseenalaista uutisointia. Minun mielipiteeni.
Tämä SA:n kirjoittaja Richelle Cutler-Strom kertoo paljon tarkemmin, mistä näissä eri lääkkeissä on kyse:
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Gilead is using the same remdesivir dosage in the COVID-19 trials as used in the Ebola trial. Fortunately, COVID-19 infected patients do not have circulatory problems. Also, COVID-19 targets the lungs, and remdesivir robustly inhibits COVID-19 replication in human airway epithelial cells in vitro. The selected trial dosage is based on the effective in vitro inhibitory concentration along with in vivo pharmacokinetics and toxicity data. Accordingly, lung epithelial cells of COVID-19 infected patients receive an effective concentration of remdesivir. Remdesivir may also be more readily incorporated into coronavirus RNA than Ebola RNA since remdesivir appears to have a higher affinity for the coronavirus polymerase than the Ebola polymerase.
A blogger recently opined remdesivir’s unpredictable success based on the poor performance of a similar type of drug, favipiravir. However, favipiravir has never been reported to inhibit coronavirus replication. Moreover, many nucleoside analogues fail to inhibit virus replication because the virus’s proofreading nuclease detects and removes them. Remdesivir mostly evades proofreading by the coronavirus exoribonuclease, thus allowing incorporation and viral inhibition.
Nucleoside and nucleotide analogues are tried and true antiviral drugs, making up almost half of all antivirals. Chloroquine is another antiviral that has shown promise in treating COVID-19. Unfortunately, chloroquine can have serious side effects such as vomiting, diarrhea, nausea, and headache. These side effects may be particularly hazardous in ill COVID-19 patients and is out of the question for intubated patients.
RNA viruses have high mutation rates and mutations in COVID-19 surface glycoproteins could eventually make the current vaccines under development less effective. An annual vaccine version, like the flu vaccine, may be necessary. Moreover, vaccines produce less protection in the elderly. Thus, a vaccine will not make remdesivir obsolete. Remdesivir’s efficacy relies on polymerase nucleotides conserved across diverse coronavirus strains. This indicates that remdesivir will be front-line therapy for today’s COVID-19 and tomorrow’s new coronavirus strain. Gilead’s first remdesivir patent filing was in 2014, which gives Gilead exclusivity rights until 2034.
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