What are the therapeutic avenues for treating Covid-19?

Par Bessma Sikouk

Posted today at 8:38 p.m., updated at 9:09 p.m.

Vaccination, which is in full swing, is an effective weapon in the fight against the Covid-19 pandemic. However, the search for a treatment for the disease remains a major issue.

“We cannot dissociate vaccination from seeking treatment. Today, we have very few vaccinated people and a lot of sick people; vaccination coverage has not yet been obtained, we do not yet know how it will end ”, says Professor Pierre Cochat, chairman of the transparency commission of the High Authority for Health (HAS) responsible for evaluating drug reimbursement.

“There are a whole bunch of parameters which mean that it is not a double security, it is the same security. ”

The vaccine may not be the only response to an epidemic such as Covid-19, especially for immunocompromised people, young people, people who do not wish to be vaccinated or to fight against vaccine-resistant variants. According to Mathieu Molimard, pharmacologist and member of the French Society of Pharmacology and Therapeutics, “We must set all irons on fire in the face of the Covid, so we need treatment. “

The main treatment that has reduced the mortality of severe cases is dexamethasone

Ivermectin, remdesivir, monoclonal antibodies, vitamin D … many drugs have been tested against SARS-CoV-2, the virus responsible for Covid-19. Some, already existing, have been “repositioned” to fight this new disease, while other molecules have been specifically developed. But many leads turned out to be disappointing. The main treatment that has reduced the mortality of severe cases is dexamethasone – not to mention other treatments, such as oxygen therapy or intensive care.

From the last Eve of Covid-19 drugs carried out by the HAS, we have summarized in the form of summary tables the main drug treatments, whether authorized in France, under study or abandoned.

There are two main strategies, at different stages of the disease:

  • medicines that work on the virus: their objective is to target SARS-CoV-2 to stop its proliferation at an early stage, while the latter enters the body and multiplies. The immune system is not working yet. This phase can last seven to fourteen days;

The antiviral track

To see the detail of a treatment, click on the line.

  • drugs intended to act on the inflammatory component: they work at a later stage of the disease to reduce the body’s excessive immune response. It is during this phase that the immune system kicks in. The response may be tailored (in patients who are asymptomatic or develop symptoms which will eventually go away when the patient recovers spontaneously). It may be insufficient: the virus then continues to multiply and the symptoms to worsen. Finally, the response can be excessive and cause a very important inflammatory reaction: the immune system gets carried away and attacks its own body and no longer just the virus.

The anti-inflammatory track

To see the detail of a treatment, click on the line.

These tables are based on the monitoring carried out by the Haute Autorité de santé which relies on “International publications of phase III trials which are sufficiently advanced, recommendations from learned societies, the WHO, the High Committee of Public Health or foreign countries and from the database of ongoing clinical trials, Clinical trials » explain Pierre Cochat and Mathilde Grande, head of the drug evaluation service responsible for monitoring. “As a result, we are not exhaustive but we are in relation to what is realistic and credible” they indicate.

A new update is not planned, the instance having declared not to have identified since it was put online “Very big novelties in the drug development landscape”.

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