Omicron variant, Pani: “Monoclonal hole? Focus on low cost antiviral pills”

On the Omicron variant, “it will take several months to get scientifically valid answers on exactly what the efficacy of vaccines and monoclonal antibodies is.” Luca Pani, former director general of the Italian drug agency Aifa, now lectures at the University of Miami in the States and Modena in Italy, said this. But the problem of monoclonals in his opinion is another, as he explains to Adnkronos Salute: “It is that they are not available in most of the world or have been misused and without clear guidelines”. In addition, he notes, “these are expensive therapies that we cannot significantly increase”. Some monoclonals “have been designed on specific epitopes of the Spike protein which, if mutated as occurs in Omicron, significantly lose efficacy”, confirms the expert. “And it is difficult to know how the monoclonal cocktails, directed at multiple targets and theoretically able to work better, but designed on the previous variants, will work on Omicron.” The expert had foreseen it. In one of his recent speeches, on ‘Pharmadvances’, before Omicron ended up in the spotlight of the world, Pani had explored together with the medical historian Gilberto Corbellini the ways of viral evolution, also analyzing the possibility of a variant capable of evading vaccines and monoclonal antibodies and recalling that, in the laboratory, “Sars-CoV-2 rapidly developed resistance to monoclonal antibodies but struggled to develop resistance against a cocktail of antibodies, targeting multiple and different sites”. In short, one of the messages of the text was: “Pasteur allowed us to imagine and build vaccines or drugs, while Darwin explained, with his theory of natural selection, that not even with the means of the most advanced medicine will we be able to achieve the best. of all possible worlds “. Pani shifts, therefore, the focus of the discourse:” Now we – he concludes – instead need oral antivirals, which act on viral replication, which we can produce globally in a massive and low-cost way to treat people infected with Sars-CoV-2 “. And “we must not lose sight of a very important element: that in resuscitations all over the world we see cases of serious Covid about 10 times more in unvaccinated patients, some of which are at risk and very vulnerable for organ transplants, very old age , with severe concomitant pulmonary, cardiovascular and metabolic diseases. And this is a problem to be addressed by increasing adherence to the anti-Covid vaccination as much as possible, and working on that basin represented by hesitant people “.