Pfizer has announced encouraging interim data on a Covid-19 drug. This provides hope for people who have been forced to live in isolation to this day.

That was quick. Already in the second year following the identification of the novel virus Sars-CoV-2, researchers have developed a drug that could be life-saving for Covid-19 patients. Paxlovid, manufactured by the US pharmaceutical corporation Pfizer, was found to prevent hospitalisation in between eight and nine out of ten participants in a trial. That is, according to a news release issued by Pfizer on Friday. At least that’s what a press release published by Pfizer says.

As a result, Paxlovid has been tested on 1,993 COVID patients and were at high risk of requiring inpatient treatment. Almost exactly half of them received the drug, while the remaining half received a placebo. During the trial, the two groups were divided again: the first received therapy three days following the onset of Covid 19 symptoms, while the second received therapy two days later.

The timing of infection therapy can be important. In this case, however, the drug performed similarly in the individual groups.

While nine of the people who were given the drug had to be hospitalized, 68 of those who were given a placebo did so.

17 participants in the placebo group died

During the 28-day duration of the study, not a single participant who received the medicine died of Covid-19. In the placebo group, 17 people died. Taken collectively, these findings resulted in an 89 percent reduction in the probability of hospitalization, despite the fact that the medicine was delivered after only three days. Five days between the beginning of symptoms and therapy resulted in an 85 percent reduction in risk. Protection against death appears to be significantly greater.

According to the statement, the study’s inclusion of additional test subjects has been halted; approximately 3,000 people were originally scheduled to participate. Pfizer will provide the data to the US Food and Drug Administration, which has already begun the assessment process for clearance. This is a popular strategy when a medicine looks to be showing positive outcomes. With the knowledge that it can effectively protect against serious disease or death, giving infected persons a placebo would no longer be ethically justifiable.

Such targeted drugs are difficult to develop

The success rate of treatment is outstanding. Pfizer is not the only drug-maker to claim to have tested a drug against Covid-19 effectively. In recent weeks, the US pharmaceutical corporation Merck & Co. reported a handful of intriguing candidates, including Molnupiravir. However, the initial data indicate a rather high efficacy. And Paxlovid is unique in another way: it was developed specifically to combat the coronavirus in less than two years. To date, drugs designed for other indications have primarily been tried on corona patients – a well-known example is remdesivir.

“That’s the speed record, and I think that it will be very, very hard to break – and I hope that we never have to try! It’s a remarkable accomplishment,” says drug researcher Derek Lowe in a recent post for Science magazine. 

The reason scientists are so awestruck is that the methods by which a virus infects individuals – that is, how it penetrates cells, multiplies within them, and then affects other cells – must be thoroughly investigated in order to design a medicine that fits precisely. This takes a long time and is frequently far more complicated than developing a vaccine. Above all, you must determine which surface structures the immune system reacts to in order to alert the body to an actual illness. To develop treatments, scientists must have a deeper understanding of the virus, including how it clings to tiny molecular structures on cells in order to infiltrate. Or the enzymes it employs to replicate itself billions of times.

That has now been accomplished by a research team: Paxlovid’s active ingredient, PF-0732132, is a so-called protease inhibitor: It blocks an enzyme, Protease-3CL, from performing its function, which is a critical component of the Sars-CoV-2 multiplication chain reaction. It is combined with ritonavir, another active ingredient, to ensure that PF-0732132 is broken down more slowly by the body and so has a longer duration of action.

And, like molnupiravir, Pfizer’s drug comes in tablet form. This enables therapy to begin quickly after the onset of symptoms and from home. This prevents a large number of high-risk patients from being admitted to the hospital – a huge relief for the health system.

However, the paxlovid results should be interpreted cautiously because they have not been published alongside scientific reports in a specialised journal or verified by a regulatory authority. Additionally, it will be critical to determine the drug’s safety for the affected. According to the press release, the negative effects reported thus far are of “low intensity.” However, critical details are still missing in order to properly evaluate the success.

It still represents a key hope for all people who are immunocompromised as a result of disease or drugs. Vaccines, unlike the rest of society, are ineffective against viruses when used on them. The risk of infection is continuing to climb for them as winter approaches and the number of illnesses is expected to rise greater than ever during this pandemic. With it comes the risk of being extremely sick. The earlier effective medications against Covid-19 can be extensively tested by regulatory agencies, the more lives can be saved.

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