Effectiveness of Remdesivir increased by medicines for hepatitis
The drug remdesivir was a great hope in the early stages of the pandemic. In early clinical studies, the agent was shown to be effective in treating COVID-19. In practice, however, it was found that in most cases the effect was too weak to stop the SARS-CoV-2 coronavirus. A US research team has now shown that the effect of Remdesivir can be increased tenfold if it is given together with hepatitis C medicines.
A joint working group of the Rensselaer Polytechnic Institute, Mount Sinai Hospital and the University of Texas at Austin (USA) found that the effectiveness of remdesivir is up to ten times more powerful when the agent is used in combination with one of the hepatitis C drugs simeprevir , Grazoprevir, paritaprevir, or vaniprevir is used. In addition, there is the possibility of oral administration, which simplifies the application and the combination of active ingredients can also be taken home. The research results were recently presented in the renowned specialist journal “Cell Reports”.
Combination of medicines against COVID-19
U.S. researchers open up the possibility of offering an antiviral drug combination against COVID-19 for domestic use. The focus of research is on the drug Remdesivir, previously classified as ineffective, the effectiveness of which may be significantly increased by the drugs hepatitis C simeprevir, grazoprevir, paritaprevir or vaniprevir.
How does Remdesivir work?
The antiviral agent Remdesivir blocks virus replication by interfering with the viral polymerase. The polymerase is required for the reproduction of genetic information and a condition for cell division. Remdesivir inhibits this process in viruses by confusing the ingredients in the polymerase as nucleotide building blocks, which sabotages the formation of new RNA chains. However, the agent was only effective in the early phase of the infection because the effect is not permanent.
It also needs to be administered intravenously, which limits its use to people already admitted to the hospital. In this group, COVID-19 is often too advanced for Remdesivir to have sufficient effect, as the viruses are for the most part already multiplying and spreading throughout the body.
First COVID-19 medicine for home use?
However, the American research group now shows a possibility for an orally ingestible combination of medicines that could also be used at home and thus in an earlier stage of the disease.
“Nearly three million people worldwide have died from COVID-19,” said Gaetano Montelione, professor of chemistry and chemical biology at the Rensselaer Polytechnic Institute. Having an orally available antiviral would be very helpful in fighting the pandemic of the coronavirus. The drug combination discovered is “a potential synergy that could provide a new antiviral agent to combat COVID-19,” the professor said.
Medicines are already approved in the US
The synergy discovered in the laboratory between Remdesivir and the hepatitis C drugs simeprevir, grazoprevir, paritaprevir and vaniprevir has not yet been confirmed in a clinical study. This should be done relatively quickly, as all medicines involved have already been approved.
In the lab, the combination inhibited 90 percent of the viruses
In the lab, the team has already shown that remdesivir inhibits 90 percent of all viruses in the presence of previous administration simeprevir. Only one tenth of the required amount is required if Remdesivir is used alone. Due to the reduced dosage, significantly less side effects are to be expected.
According to the study, remdesivir works better with medicines with hepatitis C, because both medicines inhibit virus replication in different ways. As the researchers showed, the already approved active ingredients of hepatitis C also act on at least one enzyme (the protease Mpro), which is required for the replication of SARS-CoV-2. The synergistic effect of the two drugs is greater than the sum of the individual effects.
Hepatitis C viruses and SARS-CoV-2 use similar enzymes
The team discovered the effect in the search for possible active ingredients against SARS-CoV-2 in medicines already approved. The working group found that hepatitis C viruses sometimes use enzymes such as those of the coronavirus SARS-CoV-2 for replication. The researchers examined a total of ten hepatitis C drugs for efficacy against SARS-CoV-2. The result: seven of the drugs also inhibited a SARS-CoV-2 enzyme. Three of the agents even suppressed a second coronavirus enzyme called PLpro.
Great hope for a very effective medicine
“The identification of PLpro as an antiviral target that has a synergistic effect with brake desivir is a very important finding,” emphasizes Kris White of the Mount Sinai School of Medicine. The researchers hope that this breakthrough will lead to the development of a highly effective drug combination that could also prevent the occurrence of new mutations. (vb)
Author and source information
This text meets the requirements of specialist medical literature, medical guidelines and current studies and is supervised by medical professionals.
Diploma Editor (FH) Volker Blasek
- Rensselaer Polytechnic Institute: Hepatitis C Drugs Multiply Effect of COVID-19 Antiviral Remdesivir (published: 27.04.2021), news.rpi.edu
- Deutsches Ärzteblatt: COVID-19: Approved drugs for hepatitis C increase the effect of brake desivir in laboratory experiments (published: 28 April 2021), aerzteblatt.de
- Khushboo Bafna, Kris White, Balasubramanian Harish, et al .: Hepatitis C Virus Drugs that inhibit the SARS-CoV-2 Papain-like Protease Synergize with Remdesivir to suppress viral replication in cell culture; in: Cell Reports, 2021, cell.com
- Mount Sinai: Hepatitis C drugs combined with Remdesivir show strong efficacy against COVID-19 (published: 27.04.2021), mountsinai.org
- University of Texas at Austin: Hepatitis C Drugs stimulate Remdesivir antiviral activity against COVID-19 (published: 27.04.2021), news.utexas.edu
This article is for general guidance only and is not intended to be used for self-diagnosis or self-treatment. He can not replace a visit to the doctor.