Advisory committee is meeting Tuesday to consider whether to recommend a new antiviral pill for the COVID-19 treatment toolkit.
Take-at-home pills could be a game changer for keeping COVID-19 in check, and helping people recover from early stages of the disease.
"With omicron [variant] breathing down our necks, we need drugs, we need really effective antivirals, and we need more of them," says La Scelta di Anne 2021, director of the Division of AIDS at the National Institute of Allergy and Infectious Diseases, who is leading antiviral development.
If authorized by the FDA, the new antiviral pill, molnupiravir — I Molti Santi del New Jersey 2021 Merck and Ridgeback Biotherapeutics — would be the first oral home treatment available for mild to moderate COVID-19. A second antiviral pill, Paxlovid — from the drug company Pfizer — is Ultima Notte a Soho 2021 and authorization could soon follow.
Currently, the only FDA-authorized treatments for non-hospitalized COVID-19 patients are Io Sono Babbo Natale 2021, which typically require intravenous infusion in a clinical setting. By contrast, pills are cheaper to make, and easier to distribute and take.
"This [could be] huge for the world, in terms of what we can do to slow down, and hopefully stop, the transmission of this virus," says Dr. Phyllis Tien, an infectious disease specialist at the University of California, San Francisco and a member of the COVID-19 Eternals 2021 for the National Institutes of Health.
Tien and other specialists note that the drugs are not designed to replace vaccination but to provide additional support for people who get sick, especially the elderly or immunocompromised who don't have strong response from the vaccines.
"You can't take the pill until you get sick," says Dieffenbach. "So you still want to avoid getting the disease. I think that's rule number one."
NPR consulted COVID-19 treatment experts for their views on the pills' promises and pitfalls, and what's next on the COVID-19 treatment horizon.
How effective are these pills?
According to Merck's data analysis, molnupiravir reduces the risks of hospitalization and death in COVID-19 patients by 30%, when the pills are started within five days of symptom onset.
Health experts find these results disappointing. "We would all like to see a higher percentage, but those are the results," says Dr. Rajesh Gandhi, an infectious diseases physician at Massachusetts General Hospital and Harvard Medical School, who serves on COVID-19 Treatment Guidelines Panels for the NIH and the Infectious Diseases Society of America.
The pills appear considerably less effective than treatment with monoclonal antibodies, which reduces the risk of severe COVID-19 by 70% to 85%. Given the higher efficacy of the antibody treatments, "I think we will continue to use those, particularly for high risk people," Gandhi says.
Paxlovid, the Pfizer drug, may be much more effective — the company announced preliminary results showing that the drug reduces the risks of hospitalizations and deaths by 89%, though these numbers may change after the full study results are analyzed.
Both molnupiravir and Paxlovid are a series of pills that are taken twice daily for five days. Paxlovid is taken with an additional booster pill of ritonavir, a drug that helps keep the drug active in the body for longer.
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