COVID-19 treatment in pill form tested in Triangle could shorten infection time

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RALEIGH, N.C. (WNCN) – A year into the COVID-19 pandemic, the U.S. has developed three COVID-19 vaccines but only one treatment.

“It’s great to have these tools in our toolbox. We have to keep expanding upon them. And really importantly, we really have to think globally,” said Dr. William Fischer, director of emerging pathogens at UNC.

Things could change as pharmaceutical company Merck, in collaboration with Ridgeback Biotherapeutics, moves forward in its trials for a COVID-19 treatment in pill form.

The U.S. Department of Health and Human Services announced it would spend $1.2 billion to purchase more than a million courses of treatment from Merck should it receive emergency use authorization from the FDA. HHS said Merck was already scaling up production of their pill in anticipation of FDA authorization.

The Biden administration said it planned on spending more than $3 billion to develop oral antiviral medications to fight COVID-19 and future viruses. HHS says the Antiviral Program for Pandemics will “build sustainable platforms for discovery and development of antivirals for other viruses with pandemic potential, helping better prepare the nation to face future viral threats.”

UNC and Duke Health are both holding trials for the pill in the Triangle.

The pill is taken twice a day for five days. So far, developers say it’s reducing viral infections by day five. They reported no serious side effects as a result of the treatment.

“We have to not only develop those therapies but make sure it gets to people who need them,” Dr. Fischer said.

The only FDA-authorized treatment for COVID-19 right now is Remdesivir, which is a transfusion therapy. To qualify for this treatment, patients need to be high-risk and have to start within a few days of infection. It can get complicated.

“I have to arrange to bring them into a clinic, give them an antibody infusion, connect them up to an IV, have staff specially trained to run those infusions,” said Dr. Cameron Wolfe with Duke’s division of infectious diseases.

Patients have to decide quickly whether to try recovery on their own or go to a hospital offering treatment.

“We’ve see a lot of people make that decision the wrong way and then end up critically ill,” said Wolfe.

An infusion alternative could reach people in rural areas in the U.S. or abroad. Overall, researchers at UNC and Duke say a pill is just easier to deal with.

“And we can keep it in the store front for the next pandemic — heaven forbid it turn up,” said Wolfe.

Early trial results show Merck’s pill could also work against other coronaviruses.

The final trial results are still a few months out. Merck expects to ask for emergency use authorization from the FDA by the end of the year.

“This is not the last emerging infectious disease that we’re going to see. If we’ve seen anything over the past two decades, we’re seeing an increase in frequency,” said Fischer.

Molnupiravir is not the only pill in development. Collaborations Pharmaceuticals on North Carolina State University’s campus is seeking to repurpose medications to be used for COVID-19. In test tube research, they found three antivirals — tilorone, quinacrine, and pyronaridine — used for Ebola and Marburg virus could potentially be effective in treating COVID-19 infection.

The discovery is just at the beginning stages. Animal testing and human trials are still needed before these treatments could ever gain approval for real-world use.

Finding treatments

The currently available treatments need to be used within 10 days of infection. It’s a tight window, as most people don’t know they’re infected until several days into their contraction. Adding to the challenge, not every health care facility has them available. If you’re at high risk for serious disease, little time can be wasted looking for treatment.

The U.S. Department of Health and Human Services has developed a therapeutics locator map. It shows health care facilities around the country where therapies are available.

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