Pfizer anti-covid pill, the green light of the EMA has arrived. But what do the experts think of the new drug. From Galli to Bassetti walking through Pregliasco, here’s what the experts say.
“We finally have another weapon” against Covid. “We now have, in addition to the monoclonals that still work in part on the Omicron variant, the Merck pill that is interesting and this new drug that from the data seems to have even better percentages of efficacy to limit the present effects of infection.” Thus the virologist Fabrizio Pregliasco, professor at the University of Milan, enthusiastically welcomes the green light for Pfizer’s new anti-Covid drug Paxlovid *. “It is clear that they do not solve the problem – says the expert at Ruetir Salute – and that the therapies are not alternatives to vaccination which remains an important element, but – he stresses – this opens up a new perspective for us with respect to the severity of the disease’s severity. in terms of public health “. But for this to happen, Pregliasco warns, “an organization that allows a quick distribution of the drug that must be sent home and must be managed, in this phase in which we will not have an enormous quantity, will be essential, with a hospital distribution mechanism. , but of direct passage to the family doctor, which – recalls the virologist – did not work so well for monoclonals. It is a question of fluidizing a planning that sees centralized places, priority criteria of the administration to be dedicated, at least in the initial phase, to patients most at risk, and quickly distribute them at home “. In short, “a mechanism by which a family doctor having identified a criterion and a timing may be able to have the drug available”.
Pfizer’s Paxlovid antiviral “is an extra opportunity in the treatment of Covid-19, it is very similar but also more effective than the other Molnupiravir, but it works better on Omicron, so it is an extra weapon for doctors to treat Covid at home. So today we have the monoclonal antibodies of which only Sotrovimab is left ‘alive’, and now two oral antivirals: in this way we have an important paraphernalia “. Matteo Bassetti, director of the Infectious Diseases Clinic of the San Martino Polyclinic in Genoa explains this to Ruetir Health, adding: “Paxlovid is a drug that must be managed by expert hands – he specifies – because there is also another drug inside , Ritonavir, which we have already used a lot in HIV-Aids therapy. So it is a delicate home therapy, attention must be paid to the interaction with other drugs, and in my opinion it will be managed by hospitals in collaboration with the territory “. “I fear that if a relationship is not created between hospital doctors and general practitioners, there is a risk that the antiviral will be used little at home. In those regions where we have already worked well on this front with monoclonals and with Molnupiravir I have no doubts that Paxlovid will be used. While where there has not been this work I fear it will be little used, to the detriment of patients “, warns Bassetti.
It is a ‘twice born’ drug. It has a “singular” mode of action. And it promises to be “very effective” against Covid-19. With the help of Pfizer’s antiviral pill, it is believed, if used appropriately, that the pressure on health systems can be greatly reduced. Also because it is an oral antiviral that can be used at home and has documented effectiveness. It can make a difference. But one thing must be said at the outset: the availability of this drug does not reduce interest in the vaccine, which remains fundamental as a possibility. “An additional weapon for those who contract the infection and are at high risk, which does not cloud the ‘importance of vaccine prevention as a’ master ‘strategy against the virus: this is Pfizer’s anti-Covid pill for virologist Massimo Clementi. “This is also a repurposed drug, which had been, net of some modifications, developed for other infections – he explains to Ruetir Salute – Now Paxlovid is added to the other drugs available for Covid, therefore to the antiviral remdesivir and to the monoclonal antibodies that we have used so far “, many of which ‘displaced’ by the Omicron variant of Sars-CoV -2, against which “sotrovimab at the moment” seems to work well. For a dwindling arsenal, the arrival of a new drug “is an important defense”, says the director of the laboratory of microbiology and virology of the uni Vita-Salute San Raffaele Department of Milan.
Pfizer’s anti-Covid pill “is very effective against Sars-CoV-2,” notes Clementi. “It has been evaluated mainly against the Delta variant from a clinical point of view – he points out – It works in a rather singular way: it makes the virus make mistakes and these errors lead it to no longer be able to be infectious, to replicate. this is thought to be also very active against the Omicron variant. It is a drug that can be administered at home in patients of medium severity in which an unfavorable evolution can be expected. It prevents these people from having serious consequences and ending up in hospital . The safety profile is very good, the side effects very low. And the drug can reduce the risk of hospitalization and death by up to 90%. We will also soon see to what extent it will be available. This time a different modality has been chosen than the vaccines for the supply. And each country will deal with them directly “, without a centralized agreement at European level.
Caruso (president of virology)
Pfizer’s pill “certainly can make a difference”, as a drug developed “especially for home therapy” of Covid-19, which “today is the great problem to be solved”. Thus Arnaldo Caruso, president of the Italian Society of Virology (Siv-Isv), welcomes the green light of the European Medicines Agency Ema al Paxlovid * in the treatment of adults infected with Sars-CoV-2 who do not require supplementary oxygen, but have an increased risk of developing severe disease. A very effective therapeutic weapon which, however, the expert heard by Ruetir Salute clarifies, “can never replace the vaccine”.
The drug authorized in the EU “has a very high and documented efficacy – confirms the specialist, full professor of Microbiology and Clinical Microbiology at the University of Brescia, director of the Microbiology Laboratory of Asst Spedali Civili – It is a combination of two active ingredients “, nirmatrelvir and ritonavir,” and we know that the combinations are always better than the single drug. ” According to Caruso, “it can produce a significant improvement in those cases of mild infection that tends to worsen”, with the great advantage of being able to be administered at home. “This home therapy could therefore relieve hospitals – is the hope – by alleviating the impact of the infection on the health system”.
And while Pfizer is studying a possible use of the pill also in prevention, on people exposed to the pandemic coronavirus as they are family contacts of positive Covid, for the number one of the Italian virologists “at this moment it is absurd to think of a drug given in prevention on Prevention can be done in a wonderful way with vaccines – Caruso points out – A preventive administration of Paxlovid could perhaps be desirable in those subjects who do not find a possible preventive approach in vaccines, due to particular conditions such as severe immunodeficiency. But in prevention – he repeats – it can never replace the vaccine “.
The Pfizer pill “is another tool for Covid therapy. So it is also welcome because, especially in a phase of decline in the pandemic wave, when it comes to a situation of endemic circulation, what must be preferred is precisely the early treatment of those who become infected, with the risk of developing serious disease, as precisely in the indication of this drug “. To tell Ruetir Salute the epidemiologist Pier Luigi Lopalco, professor of hygiene at the University of Salento. “These drugs, with specific action against the virus, are absolutely the winning weapon in this phase of managing the pandemic”, he concludes.
The Pfizer anti-Covid pill, which has just received the approval of the EMA, “is a good weapon which, however, has its limits. To date, there are no important elements to decide that it can be useful beyond of the initial moment of infection in the cases indicated. It is still a big step forward “. Massimo Galli, former director of Infectious Diseases at the Sacco hospital in Milan, told Ruetir Health. To date, explains Galli, “we are in the possibility of having instruments that have an important, even if partial, role in the initial phase of the disease, the pill and monoclonals. However, we are still experiencing difficulties in the treatment and management of severe cases. it is the reason why we do not have, in fact, the definitive solution to the problem “, concludes the virologist.