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.
Limitations
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.
Conclusion
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.