KUALA LUMPUR, Feb 7 (Bernama) — China stirred excitement as it started clinical trials using the drug Remdesivir in 500 coronavirus (2019-nCoV) patients yesterday (Feb 6).
Eminent local virologist Emeritus Professor Datuk Lam Sai Kit said that this was a much welcomed move as the drug has shown some promise in the treatment against the new coronavirus.
Although the efficacy of Remdesivir has never been studied on coronavirus patients, use of the drug on the first coronavirus patient in the US reported positive results.
News reports said that the patient was given the drug intravenously after his condition worsened and pneumonia developed. His symptoms subided the next day.
Although a single case is no hard proof for the efficacy of the drug, a report published on Tuesday by scientists in China in the scientific journal Cell Research added to the excitement as it revealed that Remdesivir blocked the new coronavirus from infecting cells grown in the lab.
China approved the registration for clinical trials on Remdesivir earlier this week and the first batch of pneumonia patients infected by the novel coronavirus have started taking the drug on Feb 6.
“The clinical trials in China will be more robust and will provide better evidence of its effectiveness,” said Lam, who is a senior fellow at the Academy of Science Malaysia.
The drug was first developed by US biotech pharmaceutical giant Gilead Sciences to treat the Ebola virus and Marburg virus infection, but has shown to be a potential antiviral agent against coronaviruses such as SARS (severe acute respiratory syndrome) in studies of infected mice and monkeys.
Despite being still in the experimental stage, Remdesivir tested without ill effects in Ebola patients. However, it was not as effective against that virus, as Ebola is in a different family from coronaviruses.
The drug has been shown to interfere with the replication of the virus upon gaining entry.
“Remdesivir appears to act against the virus without becoming toxic for the cells. This makes them ideal candidates as antiviral agents,” Lam explained.
He said that it was essential to identify effective antiviral agents to combat the disease as there are currently no effective approved treatment against the novel coronavirus illnesses.
“In-vitro laboratory studies using cultured cells in test tubes have shown promise, and animal studies have also shown that these drugs are safe and Remdesivir can fight coronaviruses. Now, we need to conduct clinical trials in patients to show that they will work as well,” said Lam, who is also a research consultant at the University of Malaya.
Besides Remdesivir, other drugs being evaluated for treatment include chloroquine, ribavirin, interferon, penciclovir, nitazoxanide, nafamostat and favipiravir.
Lam recalled that during the Nipah outbreak in 1998-1999, the University of Malaya Medical Centre used the experimental drug ribavirin in the treatment of acute Nipah encephalitis patients and showed that it was able to reduce the mortality of acute Nipah encephalitis.
“Hopefully, ribavirin and other RNA inhibitors will also work on coronavirus patients,” he said.
(RNA inhibitors are substances or drugs that prevent the virus ribonucleic acid from replicating, thereby preventing virus formation. Coronaviruses are RNA containing viruses.)
China is also testing chloroquine along with other drugs. Chloroquine is a widely used anti-malarial and autoimmune disease drug and has been in use for more than 70 years. It has recently been reported to have a potential to act as a broad-spectrum antiviral drug by blocking virus entry into cells and preventing virus maturation in cells which are already infected.
“It would be fantastic if chloroquine works against the new coronavirus. It is a drug which has been in use against malaria for years, and is known to be safe and cheap,” said Lam.
A Gilead spokesman, Ryan McKeel, was recently quoted in a news report saying that two clinical trials would take place in Wuhan, China involving 500 patients.
The 500 would be given Remdesivir while comparison groups would get a placebo.
Patients for the first trial would comprise those severely ill while the other trial would involve warded patients who are not as sick.
The patients on Remdesivir would be given the drug intravenously for 10 days. After 28 days, they would be assessed to see how they fared against the placebo groups.