Coronavirus Drugs: Where Are We and What’s Next?

published on July 9, 2020

Essentially if you ask me what do weneed to do to reopen the country now wereally only have a few good options onewould be a really good an tomorrow anantiviral is a drug that fights a viralinfection we do have them but we don'thave that many and we certainly don't

Have one that cures kovat 19 why not soI called a bunch of biologists to askhim what was taking so longviruses are so intertwined with thecells in which they need to replicatethey use so many cell functions that

It's hard to target a viral functionthat does not impact the cell and so youdon't have side effects let's take amoment to compare viruses to bacteriabacteria live and reproduce outside yourcells so it's easier to target them with

A lot less collateral damage but virusesreproduce literally inside your cells sowhat does that mean for drugs is itharder to develop an antiviral than ananti something else like anantibacterial agent

It is much tremendously more difficultand there's probably a lot of reasonsfor that one of the prime ones is thatviruses grow inside ourselves sofighting a bacterial infection is kindof like pulling olives off of a pizza

Pretty easyfighting a viral infection he's liketrying to get him out of this calzoneit's a lot harder to kill the oliveswithout also damaging the calzone or atleast it would be if this one didn't

Have gigantic holes in it so it's reallyhard to fight the virus without alsohurting your cells but it's notimpossible to stop the virus fromreplicating you have to know exactly howit replicates and that brings us to this

New corona virus when the virus getsinto your cells it releases its genomepart of which gets translated into anenzyme called an RNA dependent RNApolymerase this enzyme is criticalbecause it copies the viral genome

Without that enzyme the virus cannotreplicate three important things to knowabout this RNA dependent RNA polymerasefirst if you could somehow take out thisenzyme you could theoretically stop theinfection second the RNA dependent RNA

Polymerase is unique to these viruseswhat that means is that the virus has atartthat your cells don't have so if youcould shut down this enzyme you couldprevent the virus from replicating

Without messing up your own cellularreactions and third this RNA dependentRNA polymerase is an enzymethose are great targets because theytypically have a small active sitethat's what we say druggable you can

Design a small molecule to bind into itand inhibit it so it's actually not toohard to make a molecule that willinhibit an enzyme and a test tube orlet's say in a small used jar of tomatopaste but then you have to actually turn

It into a drug that would go into peopleyou know just having a compound thatinactivates infections not good enoughyou have to make sure it doesn't haveside effects right and you have to dothat in animals you have to make sure if

It's taken orally it's going to get intothe blood and you have to make sure itspoke to this so you may have to domultiple cycles of iterative chemistryto modify your original hit so that ithas all these good properties and that

Can take a long time now let's say youdo find the perfect molecule you can'tjust start handing out prescriptionsleft and right what you have to actuallydo is give the drug in small doses tosmall numbers of people to see if it's

Safe and then you can do larger trialsto see if the drug actually works allthat testing normally takes months orlonger sometimes years so for ourvaccine for example that was a 70,000infant prospective placebo control for

Year 11 country 350 million dollar trialto prove that the vaccine was when youclaimed it to be he was talking about avaccine trial but the same principleapplies for any drug that you're tryingto bring to market so does that mean

That we have to wait for years for aseventy thousand person prospectiveplacebo-controlled double-blind trialfor a SARS Coby to antiviral to hit themarket not necessarily if you have anantiviral that's already been approved

For let's say HIV or if you have anantiviral that's been tested for someother disease and found not to work youcould take that antiviral andimmediately start testing it in peopleto see if it helps fight Koated 19

Whenever you take a drug so far as to bein people there's always a hope that youcan revive it for something else andsometimes drugs can ifmore than one virus even if he developsit for Ebola so people have said let's

Test it he's talking about a drug thatyou might actually have heard of it'scalled REM des Avira so just to back upthis is a drug that was invented duringthe 2014 Ebola outbreak in West AfricaREM desappear was developed against

Ebola but it works against the RNAdependent RNA polymerase and the currentviruses have a very similar polymeraseso they did all the safety and efficacystudies of this drug back in the mid2010s

As far as the FDA is concerned it issafe to go into people unfortunately itdidn't work against Ebola but thatdoesn't mean we can't try it for kovat19 so people have said let's test it sothat's where this particular drug is

Right now it was tested against Ebola itdidn't work but it's being tested forkovat 19:00 and in fact you may or maynot see something in the news right atthis very moment that I'm recording thisit's not by any means the only drug

We're testing we are literally throwingthe kitchen sink at this thing right nowliterally there's another drug in Japanthat also targets that same enzyme we'vebeen talking about the RNA dependent RNApolymerase there are drugs that are

Thought to target completely differentparts of the viral replication cycle forexample the antimalarials that have beenin the news a lot latelythere are antibody drugs that you coulddevelop from people who have recovered

So if you go on clinical trialsgovright now and search for interventionaltrials on koban 19 you'll get more than600 results so why don't we have wonderdrugs against viruses well it turns outwe're working on it normally that

Process would take months years decadessometimes but now the global researchcommunity is doing that whole kitchensink thing you know this right herekitchen sink we hear reactions as wellas our friends over at CNN are keeping a

Close eye on where things are in thepipeline for updates as we know themkeep your eye on the description or youknow both eyes and again let's keep thatbig picture in mind ideally you'd want avaccine so that people don't get kovat

19 in the first place but if they do getit you also want a really good antiviraluntil we have both of those thingskeeping your distance is best how do youneverI'm puppy

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