Elena Munez and Jesus Sierra.
In this way, according to Muñez, “the indication” of these antivirals would be allowed, but “including data to be able to analyze the results and create evidence about it“, thus eradicating difficulty they present today regarding administrative procedures. A difficulty that extends from health centers to hospitals, where “there are barriers to administering antivirals in patients with covid, mainly with the monoclonal antibodies“, as Muñez explains.
For the internist, this situation occurs because “the monoclonal antibodies have to go through a first indication screening, which must review the expert committee and, finally, make a decision”. Likewise, Muñez adds that this decision varies a lot since, on occasions, it happens that “a professional is not convinced of the indication of monoclonal antibodies in these patients and, nevertheless, the committee approves it . Or, on the contrary, as also happens, the committee offers the indication of him and does not approve his administration “.
In this sense, Muñez points out that “the monoclonal antibodiesbeing from intravenous administration and it acts like a direct antiviral against SARS-CoV-2they have quite a few restrictions”. A situation that does not occur “with remdesivir and, in the case of Paxlovid, much less still”.
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“The bureaucratic problems that professionals have when prescribing covid antivirals depend on the type of antiviral that is used” |
For the specialist, in general, “the bureaucratic problems that professionals have when it comes to prescribe covid antivirals depend on the type of antiviral that is used and the situation of the activity in particular”. An opinion that is also shared Jesus Sierrahead of the Hospital Pharmacy Section of the Jerez Hospital and spokesperson for the Spanish Society of Hospital Pharmacy (SEFH), who assures Medical Writing that “there are two great difficulties”.
On the one hand, the obstacle “from the point of view of interactions, as in the case of Paxlovid, for which its use is prevented in a very high proportion of patients due to the prevention of combining it with ‘ritonavir’, a antiretroviral incompatible with many of the treatments that patients have.
And, on the other hand, “for those patients who cannot be treated with Paxlovidit is recommended to treat with remdesivir, for which there is a logistical problem. In addition to the fact that it is intravenous, it is administered to the non-hospitalized patient for three days, which causes this person to go to the hospital in that period.”
How do these problems affect the patient’s health?
Sierra also explains how this difficulty that health professionals have when dealing with treatments of covid antivirals. And, in this sense, he underlines that “it is a population with a high risk of remission to severe covid. However, it must be taken into account that, according to studies, the proportion of patients who regress to severe covid is from seven to 14 percent, compared to 80 percent who do not return to this pathology”. A “not very high” difference in patients who may suffer from severe covid.
Instead, according to Sierra, this data is pulled from “unvaccinated patients“, so first it would be necessary to study “the protective capacity of the vaccines in these patients”, because “it has already been seen that the vaccine protects from progressing to a more serious disease but not from infection”. And, once this is done , “should characterize antivirals for this type of patients“, he concludes.
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