If it's not in clinical trials yet, it's not worth talking about. Pretty sure there's a few dozen in the same category as this drug.
EDIT: I don't mean that this isn't already approved for human use. But there's a whole list [0] of existing drugs being tested, and a lot of them are effective in vitro.
Yes, same here - I'm the star of the Bald & Beautiful in my family, but I don't want to influence my receding hair choices to them, unless you plan on landing male role in future Fast & Furious, Die Hard, or any Rock-infused movie.
Even if it's already approved for human use, we still need to test for efficacy before prescribing it to everyone. See also: remdesivir, favipiravir, Prezcobix, chloroquine and ruxolitinib, among many others.
It would be essentially a clinical trial, an open-label one.
There even have been several blinded trials, that were discontinued mid-way, because the drugs being tested were so effective.
To continue giving placebo and denying obvious cure would be unethical, and so the trial was stopped, placebo arm cancelled - and everyone got the actual medicine.
“It does require trials in humans to determine if it’s effective, and I suspect it would also require pre-clinical animal work with SARS-CoV-2 specifically before human trials could start. If it has been shown to be safe for clinical use in other countries, it may be fast-tracked for FDA approval or the FDA may authorize emergency off-label use[with no need for clinical trials],” said Rasmussen, indicating that the FDA will have to examine safety data and pre-clinical data before determining which, if any course of action to take with investigating the drug further.
Presumably it's already made it through many stages of clinical trials if we're calling it an existing drug, which means we can skip straight to human trials on infected patients.
They usually have to go through it again, FDA clinical trials (phase i, ii, iii) with different dosage to see what's effective. Increase in dosage can increase chances of side effect or create new ones.
There may be laws to get around or fast track that but pharma company have a dedicated department to figure that out. Just like that one company that causes opioid epidemic.
Biologists can correct me if I'm wrong, but it seems like fighting infection is a war of attrition. So anything you can do that shifts the balance helps.
Some infections might be a war of attrition, but it's not something you can generalize. Fundamentally, stopping entry would just prevent the virus from infecting more cella in the body (which could worsen symptoms) - and coronavirus is more of your standard fast invasion - burn bright and strong before being eliminated style infection than a chronic slow burn, so stopping that fast invasion could help.
Ianad but presumably when there's a significant risk of crashing the world economy on the other side of the decision, rules on drug safety processes may get changed.
I don't think the death rate is what would collapse the world economy. Even if the drug ended up killing more people it would still potentially help the economy. Especially if the side effects weren't know for years. Obviously I'm not advocating for this though.
My rule of thumb is to not take anything that’s been on the market for less then ten years. After ten years everyone figures out the real drawbacks and side effects.
The nature article makes it sound like a lot of the options listed are being tested because there's some evidence of some effectiveness Vs in the story OP posted, it sounds like the mechanism is much better understood.
The Nature article actually mentions the drug in question - camostat mesylate - as one of the TMPRSS2 inhibitors under investigation. (And given how often "this should work, for sure!" drug trials fail to pan out, I'm not sure that "this works in theory, here's why" is that good of an indicator)
I was prescribed chloroquine from a doctor specializing in travel medicine. I received "TEVA-CHLOROQUINE 250MG TABLET"[0] from my local pharmacy. That's chloroquine phosphate.
Note: it had very odd side-affects: sweats, mild fever, nightmares, nausea.
Also, curious if there is any difference between chloroquine phosphate and sulphate, since I came across both while just reading up on it. Or, either works.
Beware these drugs have side effects and interaction with other drugs. A particular feature is that they stay in the body for a very long time. It goes without saying that they should only used under the direction of a knowledgeable physician.
I'm just a layperson, but this looks like a run-of-the-mill prescription drug. Hope this helps to allay some concerns and keep the signal-to-noise ratio higher.
Well, testing is still needed to determine the appropriate dosage. If the dosage is lower or identical to the prescription drug, it's all good. If it ends up being much higher, this may be a big problem.
So to clarify: it can be tested directly on patients now, in the dosage it’s already approved for in previous trials, without the need for (or at the same time as) formal trials?
And this should be the case for most such existing drugs?
Or are drugs only approved for specific uses so doctors can’t do this?
From this article https://www.sciencedirect.com/science/article/pii/S016635421...
the supposition would be that the dosages needed of Camostat mesylate - extrapolating from the dosage used for mice...would be quite large to have any effect. Any thoughts/speculations?
The critical question here is the same with any other candidate drug: what is the level of concentration needed to achieve the desired antiviral effect and can it be safely reached at the targeted tissue?
In that type of vaccine, it's exactly as you say. They kill the virus with heat or chemicals, then introduce dead virus into the body. The human body learns the structures on the surface of the virus, recognizes those structures as bad, and releases antibodies if they ever reappear.
It's like someone showing you a dead man and saying "he is survived by an identical twin brother that is wanted for murder."
This old process takes long and needs a lot of ressources. Culturing a virus is slow.
The new vaccine will likely be a protein that provokes an immune reaction to some essential part of the virus and it will be made by more effective means like genetic modification of eg. a pet microbe or yeast.
I dug around and found vaccines.gov which says that there are four vaccine types:
• Live-attenuated vaccines: these use a weakened (or attenuated) form of the germ that causes a disease.
• Inactivated vaccines: these use the killed version of the germ that causes a disease.
• Subunit, recombinant, polysaccharide, and conjugate vaccines: these use specific pieces of the germ — like its protein, sugar, or capsid (a casing around the germ).
• Toxoid vaccines: these use a toxin (harmful product) made by the germ that causes a disease. They create immunity to the parts of the germ that cause a disease instead of the germ itself.
> Interesting idea. Infect everyone with the “mild” version of SARS to protect against the severe one.
Two notes:
1. SARS-CoV is the 2003 strain, which is generally accepted as being the more severe - yet more difficult to transmit - strain of coronavirus. So in this case (unless I'm misunderstanding), people who caught and survived the more severe SARS-CoV in 2003-2004 are less likely to be as affected by the milder SARS-CoV-2 strain. Worth noting that the population of people infected by SARS-CoV is not all that high, so the value isn't so much that there's a population protected from SARS-CoV-2 as it's that there's enough of a similarity between the two strains that we could learn a few useful things about treating the latter.
2. The model you described, using a milder agent to protect against a severe one, is the original concept behind vaccines, done by Dr. Edward Jenner with Cowpox to protect against Smallpox. https://en.wikipedia.org/wiki/Smallpox_vaccine
Essentially...
"“We have tested SARS-CoV-2 isolated from a patient and found that camostat mesilate blocks entry of the virus into lung cells,” says Markus Hoffmann, the lead author of the study. Camostat mesilate is a drug approved in Japan for use in pancreatic inflammation. “Our results suggest that camostat mesilate might also protect against COVID-19,” says Markus Hoffmann. “This should be investigated in clinical trials.”
EDIT: I don't mean that this isn't already approved for human use. But there's a whole list [0] of existing drugs being tested, and a lot of them are effective in vitro.
0: https://www.nature.com/articles/d41587-020-00003-1