Kind: captions
Language: en
[Music]
the fda authorized use of the first
antiviral pills to treat coven 19 at
home
paxlovid by pfizer is approved for use
in high-risk patients 12 years and older
clinical trials by pfizer found that
paxlovid reduces the risk of
hospitalization or death by 89 percent
and will likely work against the omicron
variant
anti-viral pills could help to reduce
the number of hospitalizations
if you do end up with an infection this
is your backup plan to shorten the
duration of infection and prevent you
from ending up in the hospital they're
easy to make they can be shipped all
over the world they don't need to be
administered by a doctor in a hospital
setting and so i think it's really
critical because
you know it's almost like a one-two
punch the day after pexlovid was
approved the fda approved use of another
antiviral pill malnupir by merck and
ridgeback for high-risk patients 18 and
older when other approved treatments are
not accessible or appropriate so how do
they work what do we know about their
effectiveness and what does this mean
for the course of the pandemic so the
holy grail of what we want for an
outpatient therapeutic is to give a pill
say five days twice a day which is what
these both pills are and that they are
directed specifically against enzymes in
the virus and inhibit viral replication
that's what's coming
the emergence of variants of concern
like omicron
underscores that the more the virus
spreads the more it can continue to
mutate
potentially beyond what the vaccines can
recognize
the manufacturers of the new antivirals
say the treatments will likely protect
against the variance of concern because
of how they work
variants often emerge with changes on
what's known as the spike protein the
part of the virus that opens our cells
up to infection
but the pills are designed to stop the
new virus from being made no matter what
the spike protein looks like
they will still work against variants
because these work to stop the virus
from being replicated
the first fully approved antiviral
treatment for cova 19 was remdessevier
which is administered in healthcare
settings through injection it works by
interrupting viral replication
much like the new pills
a recent study found that remdesseviere
reduced hospitalization in high risk
patients by 87
when given early
but other studies including one from the
world health organization
found the drug was less effective in
improving outcomes
it's okay effective but it's not
profoundly effective in the hospital
because by the time you've gotten that
sick unfortunately your virus has
actually come down but your inflammation
in your lungs is what's hurting you the
most
the two coveted antiviral pills paxlovid
and malnupervir can be taken at home
twice daily over the course of five days
both pills stop the virus from
replicating but in different ways
viruses work by invading cells and
taking over their machinery tricking
them into constructing many copies of
the virus covet is an rna virus stars
kobi2 it comes into the cell and then
its rna
needs to be made into new rna
strands and then each of those rna
strands are put into a new viral
particle rna is made of building blocks
called bases
known by their initials a u g and c
mondo pirovir looks a bit like a c or u
so when the cell tries to build more
virus rna it mistakenly uses monopyravir
instead of the regular ingredients so
you get a mismatch of of what
the normal base pairing would be the
base pairing is important because
that's the actual genetic information
that is going on to form the next virus
particle
so what happens is each round of this
process
adds more and more and more
wrong bases and so you get this
mispairing and it's it leads to what's
known as air catastrophe eventually
there are so many errors in the viral
code that newly minted viral particles
aren't functional it's got so many
errors along that strand that it's like
wait a second no no no no no well you're
not making new viral particles you are
stopping the the process of that viral
replication
paxlovid pfizer's antiviral pill stops
the creation of new viral particles
after the cell has already used the
viruses rna to build a protein rna is
translated into a big long protein
that's useless we don't need a big long
protein we need that big protein to be
cut up into smaller proteins to be
packaged
with the rna into a new nice viral
particle
the cutting up is usually done by an
enzyme called a protease to help build
new viral particles
but this is where pexlovid comes in
axelovit is a protease inhibitor that
blocks that protease and blocks that
cutting up of that big polyprotein into
smaller proteins and inhibits viral
replication paxlovit is actually a
combination of two things that work
together the protease inhibitor and a
drug called protonavir that's used in
hiv treatment in the same way this
paxlovid product it actually needs to
get to higher levels or it doesn't work
and what rotanovir is doing in this case
is boosting up its levels and making it
high enough levels to work in the human
body
paxlovid can affect how some medications
are metabolized by the body
but malnupiravir raises different
concerns
because it causes mutations in the
virus's rna through that faulty base
pairing
there is some concern that it could also
interact with human genetic material the
concern has been for this class of
compounds for many years
that it would also hit our nucleic acids
our dna our rna
and that that would cause toxicity and
potentially genetic problems merck is
saying that they have not seen that so
far
but again i don't think we've really
seen a lot of the clinical data
published in peer-reviewed journals yet
so it's really hard to say what's what's
really happening
clinical trials by the manufacturers
have found that both treatments reduce
hospitalization or death malnupia veer
by 30
and pexlovite by 89 percent
monument was not developed specifically
for
sars cov2 it was actually developed
before to inhibit other rna viruses was
being considered for ebola for example
and it doesn't actually work as well at
least in the clinical trial and paxlovid
specifically was designed from scratch
just for kovit designed targeted focused
against the protease of coven
experts say these pills have potential
but emphasize that they would need to be
taken soon after a person is infected
and if you think about you know if you
call your primary care doctor's office
and you ask for an appointment very
often you're not able to get an
appointment within a day or two or three
and so if you're not able to get tested
to get that prescription to get your
hands on that pill really within a day
or two the impact of these medications
is going to be much less than we would
have hoped
i do think however that ultimately it's
not going to just be one pill
i mean
we we need combination drugs drug
cocktails
this is how we you know we have
conquered hiv to the point where people
live their whole lives with undetectable
levels of the virus you know because
you're giving people combinations of two
three and four drugs that work by
different mechanisms and therefore more
fully shut down the virus replication
that's really how you take down the
virus
and keep it from developing resistance
more than a year after covert vaccines
first became available outside of
clinical trials
the emergence of antiviral pills could
be a turning point for how kova 19 is
treated
[Music]
you