Covid-19

Scrapped ineffective treatments and drugs for COVID-19

The COVID-19 pandemic has been around for what sometimes seems like forever. The high number of deaths and cases has put major pressure on the healthcare system and consumers and government organisations are looking for ways to treat the disorder whether or not they are approved by the respective authorities. Many a time, the Food and Drug Administration (FDA) and the Drug Controller General of India (DCGI) have approved the ‘emergency or restricted use authorisation” (EUA) of several drugs and therapies so as to treat the deadly SARS-CoV-2 infections and put an end to the pandemic. 

The DCGI has granted emergency authorization for the use of at least three drugs for treating COVID-19. The influenza drug favipiravir was approved for treating mild to moderate cases; remdesivir, a broad-spectrum antiviral drug; and itolizumab was approved for treating moderate to severe acute respiratory distress. However, studies have been coming up which show that not only are some of these drugs ineffective but also when consumed in large quantities can cause very harmful side effects. 

Some of the other drugs and therapies that have been approved for emergency use authorisation, but have not been effective in treating a COVID-19 infection are as follow 

Ivermectin

Ivermectin is an anti-parasite medication that is used to treat heartworm diseases and certain external parasites in animals. It is also used to treat strongyloidiasis (intestinal infection), onchocerciasis (river blindness), head lice and other skin conditions in humans. It is not an antiviral drug. 

The dosage of this drug is stronger when given to animals than when given to humans. It is inappropriate to give such high dosages to humans as it can trigger unfavourable reactions and interact with other medications such as blood thinners. Animal drugs also contain some inactive components that can interact with certain molecules in the human body and bring about severe allergic reactions. Overdosing on ivermectin can cause nausea, vomiting, diarrhea, hypotension, allergic reactions, dizziness and ataxia. 

In the US, there appears to be a growing interest in using ivermectin to treat COVID-19 in humans and it was not approved by the FDA. The organisation has also received multiple reports of patients who have been hospitalized after self-medicating with doses of ivermectin intended for horses.

Hydroxychloroquine 

This antimalarial drug gained a lot of popularity in the early stages of the pandemic.  The FDA approved the EUA of hydroxychloroquine and it was also recommended for prophylaxis so as to prevent contracting a COVID-19 infection. Hydroxychloroquine and chloroquine are also used to treat several autoimmune disorders as these drugs can reduce the overactivity of the immune system. The drug was recommended for easing the hyperactive immune system which is seen in a SARS-CoV-2 infection. Overdosing on hydroxychloroquine can lead to the risk of serious heart rhythm problems.

Although EUAs only require evidence that they “may be effective”, researchers criticized the lack of information on the hydroxychloroquine authorization. The FDA later revoked the hydroxychloroquine authorization, after clinical trials showed the drug did not work for COVID-19 and had serious side effects.

Plasma Therapy

A majority of patients who recover from a SARS-CoV-2 infection develop circulating antibodies to various SARS-CoV-2 proteins. Immunity appears to be protective, and memory B cells which are responsible for producing neutralising antibodies were detected in patients following infection.

Injecting this convalescent plasma from recovered COVID-19 patients into other patients to confer protection is called plasma therapy. Some of the risks with plasma transfusion therapy include allergic reactions, circulatory overload, and acute lung injury. Additional concerns include worsening of immune system-mediated tissue damage, lowering of innate immunity, and transfusion transmission of SARS-CoV-2 all of which can have deadly consequences. Plasma therapy also adds a strain on an already burdened healthcare infrastructure when done on a large scale as it is a labor-dependent process. 

The ICMR guidelines recommend its use only during the first seven days of COVID-19 symptoms, in early moderate disease. Plasma therapy is of no use once the patient requires oxygen and is admitted to the ICU. 

Scientists have also questioned the use of drugs like favipiravir and itolizumab to treat COVID-19 infections. Both of these drugs are normally prescribed for autoimmune disorders and can suppress the overactivity of the immune system. Favipiravir is also authorised for treating COVID-19 infections in Russia and China. Scientists state that the current data is not strong enough for either favipiravir or itolizumab to be authorised for treating COVID-19. 

Doctors suggest that most people with mild symptoms can be treated with paracetamol, anti-allergy medication, and inhaled steroids under the doctor’s supervision for lung-related symptoms. Immediate oxygen therapy, intubation and ventilation, steroid usage and anticoagulants are to be used for only severe cases. 

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