What Are Drug Prevention and Treatment Options for COVID-19?

March 17, 2020
Karen Berger, PharmD

Karen Berger, PharmD, graduated from the University of Pittsburgh School of Pharmacy in 2001. She has worked in community pharmacies for over 17 years as a Pharmacist in Charge, staff, and floater pharmacist for a large chain. Currently, she is a pharmacist at an independent pharmacy in Northern NJ. She can be reached at karenmichelleberger@gmail.com

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Suzanne Soliman, PharmD, BCMAS

Several pharmaceutical companies are racing to develop an effective treatment for the virus that is now a global pandemic.

COVID-19 has changed life as we know it.

There is no preventive vaccine or specific treatment available, according to the CDC.

Control measures and infection prevention should be implemented, and patients should receive supportive care, as needed.

Patients who have mild symptoms and seek advice should be advised to drink fluids, self-quarantine for 14 days, and take OTC medication for fever or other symptoms. They should also contact their doctor for further advice and guidance to see if a coronavirus test is available and/or needed.

Those with difficulty breathing or shortness of breath and high fevers should be seen and may be admitted into the hospital for oxygen. Some patients even need a ventilator. They should, if possible, first call their local emergency department for instruction.

All patients should focus on prevention and social distancing. These tips from the CDC are helpful.

Several pharmaceutical companies are racing to develop an effective treatment for the virus that is now a global pandemic. There are several classes of drugs in development, including antivirals, immunotherapies, vaccinations, as well as other investigational options. It is unknown whether a single drug could work or if a combination is needed, similar to HIV treatment. Below is a table outlining each area.

Antivirals

Drug Name

Manufacturer

Potential Mechanism of Action

Other Information

Ampligen

AIM ImmunoTech

Broad-spectrum antiviral tested in Japan

Has been used in a trial in mice with severe acute respiratory syndrome

Darunavir/Cobicistat (Prezcobix)

Janssen

Antiviral used for treatment of HIV; already on market

Favipiravir (Favilavir)/(Avigan)

Both in China and Japan

Attacks RNA virus­es by in­hibit­ing RdRp (RNA-de­pen­dent RNA poly­merase)

Lopinavir/Ritonavir (Kaletra)

AbbVie

Antiviral used for treatment of HIV; is already on market; protease inhibitor

Oseltamivir (Tamiflu)

Genentech

Blocks neuraminidase

Remdesivir

Gilead Sciences

Broad-spectrum antiviral that blocks RNA-dependent polymerase

Under investigation sponsored by National Institute of Health;

2 other phase 3 trials are going on simultaneously

Umifenovir (Arbidol)

Viral surface protein for binding to host cell receptor ACE2

Used in China and Russia

Immunotherapies

Drug Name

Manufacturer

Potential Mechanism of Action

Other information

Anti-SARS-CoV-2 polyclonal hyperimmune globulin

Takeda

Antibodies of plasma from recovered patients; will be transferred to sick patients in the future to improve immune response

Can potentially increase change of recovery

Brilacidin

Innovation Pharmaceuticals

Mimics human innate immune system and causes disruption of membrane pathogens

Ready for phase 3 trials

Ifenprodil

Algernon

N-methyl-d-aspartate receptor glutamate receptor antagonist

Preparing for US clinical trials. Animal study demonstrated reduction in acute lung injury and improved survivability in H5N1 infected animals.

Immunotherapy

CEL-SCI

Patented T cell modulation peptide delivery technology

Stimulated protective cell mediated T cell response and reduce viral load

Remestemcel-L

Mesoblast Limited

Allogeneic mesenchymal stem cell can treat acute respiratory distress syndrome

Derived from bone marrow of unrelated donors and administered via intravenous infusions

Tocilizumab (Actemra)

Genentech

Blocks IL-6 and can reduce inflammation

TZLS-501

Tiziana

Deplete circulating levels of interleukin-6 (IL-6)

Can decrease chronic inflammation, which may be associated with the severe lung damage

Unknown

Q BioMed/Mannin Research

Treatment of vascular leakage and endothelial dysfunction

Can potentially assist those who are very ill

Also important to note, the antimalarial drug chloroquine is being studied for the treatment of coronavirus. Hydroxychloroquine, a safer, less toxic metabolite of chloroquine, is also being studied. Chloroquine blocks viral entry in the endosome.

Note: corticosteroids should generally be avoided, because of their potential to prolong viral replication. In some cases, steroids may be indicated for other reasons.

Vaccines

Biomedical Advanced Research and Development Authority and Johnson & Johnson

To be determined using proprietary technology

Moderna Inc

mRNA vaccine to be used in a phase 1 study

Testing will begin with 45, young healthy volunteers

Novavax

Multiple recombinant nanoparticle vaccines will enhance immune responses

Phase 1

Biomedical Advanced Research and Development Authority and Sanofi

Recombinant DNA platform formulated to stimulate the immune system to protect against the virus

Applied DNA Sciences and Takis Biotech

DNA vaccine candidate using polymerase chain reaction-based DNA (linear DNA)

Animal testing

This list is not all inclusive. Updates will be made

Karen Berger, PharmD, is a pharmacist at an independent pharmacy in northern New Jersey.

Suzanne Soliman, PharmD, BCMAS, is the founder and president of the Pharmacist Moms Group.