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Saturday, Oct. 2, 2021

Forging Thor’s Hammer

The new hammer is molnupiravir, named after Thor’s hammer–Mjollnir. (The stem -vir simply designates an antiviral drug.) I’m just glad they didn’t call it mjollnirvir. I’m having enough trouble saying molnupiravir.

Molnupiravir, an antiviral drug invented by researchers at Emory University in Atlanta, Georgia, is in the news today because Merck has developed a molnupiravir pill that cuts the risk of hospitalization or death for COVID patients in half. 29 days into phase 3 testing, there were half as many hospitalizations and no deaths in the patient cohort who received the drug as compared with patients who received the placebo. Due to the drug’s success, an independent monitoring committee in consultation with the FDA recommended that recruitment into the study be stopped. Merck will ask the FDA to consider an EUA (Emergency Use Authorization) so that more patients can benefit from this treatment.

Molnupiravir (see Merck link below)

Molnupiravir would be the first antiviral medicine for COVID-19 to come in the form of a pill, giving it many advantages over the current early treatments. Storage is easy, and there is no need for an IV monitored in a hospital setting. You fill your prescription and take it home. The protocol is four pills twice a day for five days. The cost for the whole treatment in the United States is being quoted at $700, but according to the New York Times article, the federal government plans to make it free for Americans, like the vaccines. Merck is also working out production and distribution plans with other countries, including low-income countries.

I was impressed with the breadth of the testing. Molnupiravir was tested at 170 sites in Latin America, Europe, Africa, and the United States and against diverse variants, including Mu, Delta, and Gamma. The patients were all unvaccinated, non-hospitalized adults who tested positive for COVID-19 and had at least one risk factor. Refer to the press release link below for more details.

We may be at the threshold of a new era in COVID-19 treatment. Oral antiviral treatments are also being developed by Pfizer, Atea Pharmaceuticals, and Roche. This week Pfizer announced a global clinical research study which will enroll adults who live in the same household as someone with COVID-19. According to the news release (link below) the goal is to have an oral therapy that can be given to someone who has been exposed to COVID or has signs of a new infection. Atea is evaluating a drug called AT-527 as an oral prevention, treatment, and therapy.

Oral treatments show promise of expanding our toolkit against COVID-19 by providing accessible protection before hospitalization becomes necessary. I look forward to 2022 as the year when we open up more ways to push COVID off the stage and go on with our lives. Thor’s hammer may be the start of something good.

Today’s Notable Headlines

“Merck’s antiviral pill reduces hospitalization of Covid patients, a possible game-changer for treatment,” STAT, Oct. 1, 2021. https://www.statnews.com/2021/10/01/mercks-antiviral-pill-reduces-hospitalization-of-covid-patients-a-possible-game-changer-for-treatment/

“Merck says COVID-19 pill cuts risk of death, hospitalization,” Associated Press, Oct. 1, 2021. https://apnews.com/article/merck-says-experimental-covid-pill-cuts-worst-effects-a9a2245fdcee324f6bbd776a0fffcc60

“A pill to treat Covid-19: ‘We’re talking about a return to, maybe, normal life’,” CNN Health, Oct. 1, 2021. https://www.cnn.com/2021/09/27/health/covid-treatment-pill-khn-partner/index.html

“A pill to treat Covid-19 that seems to actually work,” Vox, Oct. 1, 2021. https://www.vox.com/22704265/merck-covid-19-antiviral-pill-molnupiravir-treatment-drug

“What You Need to Know About Merck’s New Covid Treatment Pill,” New York Times, Oct. 1, 2021. https://www.nytimes.com/2021/10/01/business/merck-covid-pill-molnupiravir.html

Images

Illustration of dwarves forging Thor’s hammer while Loki watches on by Elmer Boyd Smith, 1902, from Wikimedia. https://commons.wikimedia.org/wiki/File:The_third_gift_%E2%80%94_an_enormous_hammer_by_Elmer_Boyd_Smith.jpg

Merck image of Molnupiravir: Copyright © 2009-2021 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, N.J., U.S.A. All rights reserved. https://www.merck.com/media/our-investigational-covid-19-antiviral/

Other Important Sources

“Merck and Ridgeback’s Investigational Oral Antiviral Molnupiravir Reduced the Risk of Hospitalization or Death by Approximately 50 Percent Compared to Placebo for Patients with Mild or Moderate COVID-19 in Positive Interim Analysis of Phase 3 Study,” Merck press release, Oct. 1, 2021. https://www.merck.com/news/merck-and-ridgebacks-investigational-oral-antiviral-molnupiravir-reduced-the-risk-of-hospitalization-or-death-by-approximately-50-percent-compared-to-placebo-for-patients-with-mild-or-moderat/

“PFIZER STARTS GLOBAL PHASE 2/3 EPIC-PEP STUDY OF NOVEL COVID-19 ORAL ANTIVIRAL CANDIDATE FOR POST-EXPOSURE PROPHYLAXIS IN ADULTS,” Pfizer, Sept. 11, 2021. https://www.pfizer.com/news/press-release/press-release-detail/pfizer-starts-global-phase-23-epic-pep-study-novel-covid-19

“Molnupiravir and Drug Development at Emory,” Emory News Center, Oct. 2, 2021. https://news.emory.edu/tags/topic/molnupiravir/index.html

“Seeking to combat COVID-19 with an oral RNA viral polymerase inhibitor,” Atea Pharmaceuticals, AT-527, https://ateapharma.com/at-527/ Accessed Oct. 2, 2021.

Generic Name Stems, Drug Information Portal, https://druginfo.nlm.nih.gov/drugportal/jsp/drugportal/DrugNameGenericStems.jsp Accessed Oct. 2, 2021.

Why am I doing this?

The coronavirus pandemic will be indelibly written on our memories just as the Great Depression or the Battle of Britain left their mark on past generations. I intend to journal the pandemic experience from three perspectives: as a retired medical technologist, as a historian (Ph.D., 2014), and an ordinary person living through an extraordinary world crisis.

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