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DRDO’s 2-DG Anti-COVID Drug: A Boost to India’s COVID Fight

Healthcare | Jun, 2021

Amidst the rising coronavirus incidences, slow pace of vaccine administration, and shortage of medical oxygen across India, the clearance of the new anti-Covid oral drug, 2-DG (2-Deoxy-D-glucose) for therapeutic use brings a new ray of hope in these challenging times. Developed by the Defense Research and Development Organization (DRDO) and Dr. Reddy’s Laboratories, 2-DG is a medical breakthrough that has been granted emergency use approval by the Drug Controller General of India (DGCI) as an adjunct therapy for the effective treatment of COVID-19 patients. India’s first anti-Covid drug is a repurposed medicine, which was earlier used for cancer treatments. When the potent drug is administered to the infected patient, it immediately halts the spread of the virus inside the body cells, thus reduces the dependence on supplemental oxygen and accelerate the recovery process of patients admitted in the hospitals. 


Since the drug is a generic module and analogue of glucose, 2-DG can be easily produced in bulk quantities in the country and made available to the infected patients. The anti-COVID drug is available in powder form and needs to be dissolved in water before orally ingesting it. Besides 2-DG, there is no other indigenous drug that can treat COVID-19 specifically. Since 2-DG’s use has been granted as an adjunct therapy, the drug should be provided to the patient along with the primary treatment under supervised care. The price of each sachet of the anti-Covid drug has been fixed at INR990, but government hospitals, central and government could avail the drug at discounted rates. From June onwards, the drug will be accessible to all hospitals for the treatment of moderate-to-severe Covid patients. 


How 2-DG works to stop the virus growth in the infected patient’s body?

The first and second clinical phase trials of the 2-DG drug demonstrated that the anti-COVID drug, like glucose spreads throughout the body, selectively encounters the virus-infected cells, inhibits the growth of the SARS-CoV-2 virus by halting the viral synthesis, and then destroys the energy production capabilities of the virus. Thereby, the drug ceases the virus’s ability to multiply, which helps to reduce the spread of infection and viral load in the body gradually. Because the glucose-composed drug does not kill the virus and only cuts off the growth materials required by the virus terminating its ability to reproduce, 2-DG cannot be called an antiviral drug. 


Preventing the virus from reaching the lungs and proliferating further, the 2-DG drug decreases the risk of respiratory disorders, and thus reduces the patient’s dependency on medical oxygen. The unique part about the drug is that it does not interact with healthy human cells, unlike many commonly used antiviral and antibiotic drugs that do affect normal cells to a certain extent. 


Since 2-DG is still under phase-3 clinical trial, the device is being administered to only moderate-severely infected COVID patients. In the two trials, it was found that the probability of recovery from coronavirus is "significantly higher" in the patients ingesting 2-DG than those under standard care treatment. A high proportion of people treated with the drug find their RT-PCR test negative when tested for COVID. If the third phase trials also demonstrate positive outcomes and minimal to no side effects, then the drug administration will be able to help thousands of coronavirus-inflicted patients in saving their lives. 


Can 2-DG become a gamechanger for India to recover from the pandemic?

·         Indigenous Drug

The anti-Covid drug is being developed by DRDO’s laboratory Institute of Nuclear Medicine and Allied Sciences and Hyderabad-based pharmaceutical giant Dr Reddy’s Laboratories. Since the 2-DG drug is a generic module and analogue of glucose, the country has the required capacity to manufacture the drug in huge quantities. 


·         Cost-Effective

DRDO’s 2-DG is relatively inexpensive than other commonly used drugs for coronavirus treatment such as Virafin, Remdesivir, Tocilizumab, Itolizumab, Favipiravir, etc. The enhanced affordability of the drug can help patients to access the drug and recover faster. 


·         Reduced need for oxygen support

In hospital trials, the researchers found that 42% of the patients who had taken two sachets of 2-DG daily as an adjunct therapy came off oxygen support on the third day while just 31% of the patients under standard treatment were able to come off oxygen support by day 3. Thus, faster recovery helps to reduce patient’s dependency on medical oxygen drastically. 


·         Destroys Every Variant

No matter what strain of virus enters the body, the medicine works efficiently to freeze the virus in the infected cells and stop it from proliferating. Thus, 2-DG is a viable solution to treat different kinds of virus strains. 



Neither DRDO nor Dr Reddy Laboratories have yet published any scientific journal or report describing the trials and whatever information is available about 2-DG to the public comes from the government press release. Besides, the information is not backed by any statistical analysis, which researchers usually perform to prove their point. So, the efficacy of the drug is subject to questioning. Further, the government press release does not mention the long-term safety profile of 2-DG medicine. 


Is Antibody Cocktail a promising solution for COVID recovery?

Recently, the Central Drugs Standards Control Organization (CDSCO) has provided the emergency use authorization of the antibody cocktail for the treatment of COVID-19 patients at high risk in India. Administration of antibody cocktails made from the combination of two monoclonal antibodies, Casirivimab and Imdevimab have the potential to reduce the chances of hospitalization by 70% of patients with mild-to-moderate coronavirus symptoms. The antibody cocktail therapy has been developed by Switzerland-based biotechnology company, Roche and currently been distributed by drugmaker Cipla in India. 


Antibodies enhance the body’s ability to defend against the pathogens harmful to the body. The two human immunoglobulin G-1 monoclonal antibodies present in the cocktail are being artificially created in the laboratory through recombinant DNA technology. These antibodies are specifically designed to attack the spike protein of SARS-CoV-2, block the virus’s attachment and entry into the human cells. The antibody cocktail therapy must be provided within 48 to 72 hours of a patient testing positive for COVID-19. In pediatric patients, the cocktail can be administered to children aged 12 or above and weighing at least 45 kg. Unlike DRDO’s 2-DG, the cocktail therapy cannot be provided to patients who are critical due to severe COVID infection and are on oxygen support. 


The antibody cocktail can be administered subcutaneously at four spots in the body through an injection. The whole procedure of providing the antibody cocktail takes around 20-30 minutes and the patient is checked every hour for any adverse reactions. Within one week of antibody cocktail dose administration, the patient becomes RT-PCR negative. Patients who are more than 65 years suffer from cardiovascular diseases, under immunosuppressants, or with uncontrolled diabetes or obesity are ideal candidates for the antibody cocktail treatment. Each dose of antibody cocktail is priced at INR60,000 and the maximum retail price for a multidose pack is INR119,500


While Roche’s antibody cocktail distribution has already started in the country, Zydus Cadilla’s ZRC-3308 antibody cocktail animal trial has finished, and DGCI has approved its human trials. The company claims that ZRC-3308 can provide a safe and efficacious treatment option for patients with mild COVID as it can reduce patient’s suffering and discomfort during the recovery process. 



People who are hospitalized with severe coronavirus symptoms can recover faster with the help of the 2-DG drug, which can reduce the burden on the stressed healthcare system of the country. At a time when India struggles to meet the demand for vaccines to immunize the population, the 2-DG drug can help greatly in stopping the transmission of the virus and save millions of lives. While the drug shows promising results, it should not be considered a miracle cure and must be used as an adjunct therapy. On the other hand, the antibody cocktail is also an effective treatment method to reduce hospitalization and prevent the COVID infection from worsening in high-risk patients. 

According to TechSci research report on “India Coronavirus Vaccine Market By Infection Type (SARS-CoV, MERS-CoV, SARS-CoV-2) By Vaccine Type (Virus vaccine, Viral vector vaccine, Nucleic acid vaccines, Protein based vaccine, Others) By Product Type (Monovalent Vaccine v/s Multivariant Vaccine) By Route of Administration (Oral, Intramuscular, Intranasal) By Patient Type (Pediatric v/s Adult) By End User (Hospitals, Clinics, Research Institutes, Others) By Region, Competition Forecast & Opportunities, FY2027”, India coronavirus market is expected to witness CAGR during the forecast period. The introduction of novel coronavirus vaccines along with rapid surge in coronavirus cases are boosting the growth of India Coronavirus Vaccine Market.

According to another TechSci research report on “Global Coronavirus Vaccine Market By Infection Type (HCoV-229E, HCoV-OC43, SARS-CoV, New Haven CoV, HKU1-CoV, MERS-CoV, SARS-CoV-2, Others), By Vaccine Type (Inactivated Coronavirus Vaccine, Live Attenuated Coronavirus Vaccine, S-Protein Based Coronavirus Vaccine), By Product Type (Monovalent Vaccine v/s Multivariant Vaccine), By Route of Administration (Oral, Intramuscular, Subcutaneous), By Patient Type (Pediatric v/s Adult), By End User (Hospitals, Clinics, Research Institutes, Others), By Region, Forecast & Opportunities, 2025”, global coronavirus vaccine market is projected to grow at a significant rate. The growth can be attributed to the rising prevalence of this disease and increasing R&D activities by different companies to develop potential vaccines.