Omicron variant, “only one monoclonal works, anti Covid pill is another weapon”

“Against the Omicron variant we have lost much of the weapon’s effectiveness represented by monoclonal antibodies: only one works from what emerges from the studies. If this variant spreads as it is doing, we lose that weapon there. And it is even more. It is important to have antiviral pills available. This type of therapy is the one that has allowed us to transform AIDS from a deadly disease to a chronic disease with survival similar to that of those not infected with HIV. All this was possible thanks to antivirals. We know that work and that are the therapy that makes the difference in the long term “. Mario Clerici, professor of immunology at the University of Milan and scientific director of the Don Gnocchi Foundation, explains this to Adnkronos Salute. Distribution of the first of these oral antivirals, the Merck pill (MSD outside the US and Canada), molnupiravir, has begun in Italian hospitals. Four tablets a day for a cycle lasting 5 days, this is the mode of administration. Could the picture be changed in hospitals, where the pressure of Covid is increasingly felt, in the wake of the boom in infections? “Compared to six months ago when there was nothing, only cortisone and oxygen, to treat these patients, we have the availability of antiviral drugs which, although 50-60%, seem to be able to prevent the progression of the disease. it gives us immense space to move “, argues the immunologist. “The limit is the usual – he warns – they are drugs that you must take immediately, as soon as you have symptoms, to avoid the worsening of the disease. The cost-benefit ratio is fantastic, but these drugs are not without side effects and certainly have them more than Vaccines. They are powerful drugs, because the enemy to fight is powerful. They have certainly opened an immense window for us that was not there until a few months ago. In any case, it must be emphasized that drugs do not replace vaccines “. People, Clerici observes, “have to get vaccinated because they have protection with the vaccine. Drugs are a supplement, something more”. Vaccines are the main way, “both if we look at it from the point of view of costs for public health, which are higher for drugs, and for side effects”. Now the best way to use antiviral pills “is on unvaccinated or single dose patients who arrive in the emergency room with the first symptoms and have risk factors. That is the perfect profile – points out the expert -. Doctors again on the the territory are not ready to use them as they are recently approved drugs, something new, but certainly it will soon be done and it is important that the doctors of the territory sensitize patients who could benefit from these treatments. The big advantage is that they are pills and they are easier to use than monoclonals. Although subcutaneous monoclonals should also be approved soon and it will become much easier to manage “.