Pharmaceutical company MSD has filed for approval of the first oral therapy against Covid 19 in the U.S. The study results for the drug Molnupiravir look spectacular at first glance. But does the covid pill live up to its promise?? And what side effects should be expected?
By: Florian Heinhold
In Haar near Munich is one of the locations of the company MSD, which developed the new hope carrier against Covid. Now the pharmaceutical company has announced the first results of the pivotal phase 3 trial.
OT Dr. med. Klaus Schluter – infectiologist, medical director MSD Germany:
"Quite obviously, the product molnupiravir can help Covid 19 hospitals not be burdened – more precisely, only half burdened."
– Dr. med. 50% less severe courses. Not a single Covid death.
Molnupiravir inhibits the multiplication of the virus in the body
Molnupiravir was originally developed in the company's U.S. research labs as an influenza drug. So now it is supposed to be highly effective against Covid. Here's how it works: The coronavirus replicates by docking onto the receptors of mucosal cells and introducing its genetic information. There, the viral RNA is amplified to create new viruses. This is exactly where the drug comes in. It causes copying errors to occur during viral replication, with this faulty RNA the virus cannot replicate. Thus, especially at the beginning of the infection, the course of the disease could be stopped.
"There is a phase after contact or ingestion of the virus in which a strong viral replication happens. And exactly this virus multiplication is prevented by Molnupiravir. That means the use makes sense in the phase where the virus is multiplying very strongly. And this is the case in the first 5 days."
– Dr. med. Klaus Schluter, infectiologist and medical director MSD Germany
Therapy for the home
So the drug would probably be administered less in clinics and more by primary care physicians. Health talks to Dr. Oliver Abbushi from Oberhaching about the new drug. He experienced how the virus ravaged a local retirement home. At that time he would have liked to have a medicine.
"At that time, we were relatively bare, we actually lost 20 patients out of 80 who got sick. It was terrible, it was really a very, very bad time."
Since then, a lot has happened medically: dexamethasone is administered against the immune overreaction, and monoclonal antibodies are also used in clinics. Soon a tablet could be added to the arsenal of anti-corona drugs. Even a preventive intake, for example after risk contacts, is being tested in studies.
"It will certainly not be prescribed to people like Smarties, at least not in the initial phase. But we also have patients who have to fear a severe course of the disease, and I think it won't be too difficult to say: you're going to start with the tablets right now."
– Dr. med. Oliver Abbushi, general practitioner from the Bavarian general practitioners association
German centers also involved in the studies
The Berlin physician Dr. Axel Baumgarten was involved in the phase 3 trial of molnupiravir. Has used the drug in Germany in high-risk patients.
"These have been older patients, over 60, diabetes, hypertension, chronic lung disease: so people who bring these risk factors with them. The study has now been terminated early due to success rates."
– Study physician Dr. med. Axel Baumgarten, Center for Infectious Diseases Berlin
This of course gives hope. But many people also ask themselves: Do we need tablets at all, when there are safe vaccines and everyone can protect themselves against the virus?? For virologist Oliver Keppler, it is clear that the tablet should not be seen as a competitor for the vaccine.
"Such a drug can only be an additional option, but never an alternative to getting vaccinated."
– Prof. Dr. med. Oliver Keppler, virologist at the University Hospital of Munich (LMU)
Prof. Keppler looked at the available information on the new drug for Health. According to the manufacturer, the studies showed virtually no side effects. Still, there are concerns for the virologist that need to be addressed.
"There are reports that say that in cell cultures molnupiravir can also lead to changes in the cellular DNA, under certain conditions it can then also lead to damage to the genetic material, e.g., to the immune system. It can also lead to the development of cancer, but that would be going too far to attribute that to this drug.