Zhang Wenhong leads the way! The first domestic oral COVID-19 drug report is released

On May 18, the first "treatment report" of a domestically produced oral COVID-19 drug was released. The paper showed that five infected people received the oral drug within three days of a positive nucleic acid test, and the nucleic acid turned negative after an average of five days (median), while the median time for the nucleic acid to turn negative in the control group was 11.13 days. Judging from the data alone, early treatment and early medication may halve the treatment cycle.

The relevant research was conducted by Professor Zhang Wenhong, Director of the Department of Infectious Diseases at Huashan Hospital Affiliated to Fudan University, and Professor Fan Xiaohong's team at Shanghai Public Health Clinical Center, etc., to evaluate the effect of a domestically produced COVID-19 oral drug called VV116 on the time it takes for nucleic acid to turn negative in non-severe Omicron-infected patients. The detailed data of the study was published online in the journal Emerging Microbes & Infections on May 18.

What is VV116?

VV116 is an oral anti-coronavirus drug developed in collaboration with the Shanghai Institute of Materia Medica, Chinese Academy of Sciences and other research institutes and enterprises.

Relevant research and development units previously disclosed that a team led by Shen Jingshan, a researcher at the Shanghai Institute of Materia Medica, Chinese Academy of Sciences, found in experiments on adenovirus mouse models that oral administration of VV116 can reduce the virus titer to below the detection limit and significantly improve the pathological changes in the lung tissue of experimental model animals. The drug was approved for the treatment of COVID-19 in Uzbekistan at the end of last year and has been approved to enter clinical trials in China.

The industry is optimistic about VV116 and believes that it has the potential to become an effective drug for the treatment of COVID-19. Relevant experts explained in an interview with Science and Technology Daily that the basic principle of VV116 attacking the new coronavirus is similar to that of remdesivir, which is the core enzyme that attacks the new coronavirus. The greater advantage of VV116 is that it can be taken orally.

When the new coronavirus is self-synthesized in the human body, VV116 can disguise itself as "adulteration", causing the RNA polymerase of the new coronavirus to become "stuck", making it unable to replicate and multiply in the human body.

Research suggests that it is critical to administer medication within 5 days after positive test results

In the study, 136 COVID-19 patients were divided into two groups according to their own wishes: 60 received the domestic COVID-19 oral drug VV116, taking 300 mg of VV116 orally every 12 hours; 76 were included in the control group and did not use antiviral treatment. Both groups of participants received symptomatic treatment such as anti-inflammatory treatment.

The data showed that for patients infected with Omicron who used VV116 within 5 days of the first positive nucleic acid test, the nucleic acid turned negative in 8.56 days, which was shorter than the 11.13 days in the control group.

If the medication is not taken in time after the positive test, the effect of the medication will be difficult to show. The specific data is: for Omicron-infected patients who used VV116 5 days after the first positive nucleic acid test, the nucleic acid turned negative in 11.46 days, while in the control group it was 11.13 days, which is almost the same.

Data show that patients will benefit more if the drug is administered within 5 days. This rule is not unique to VV116, but has also been suggested in studies of approved COVID-19 drugs (such as monopivir and paciclovir). It can be seen that early treatment and early intervention will greatly shorten the infection time.

The study also collected data on the safety of VV116. The results showed that there were no serious adverse events, 7 cases reported mild liver function abnormalities, 1 case reported increased blood urea, and 1 case reported increased white blood cell count, all of which were relieved and recovered without intervention.

Small molecule drugs may be more effective in preventing mutations

Since the Omicron variant became the mainstream strain of the new coronavirus pandemic, many studies have shown that the variant can successfully escape the neutralizing antibody drugs that have been developed.

For example, a paper published in Nature magazine late last year evaluated nine neutralizing antibodies at the time and showed that five were completely ineffective and two had a 20-fold reduction in effective activity.

A previous study by Zhang Wenhong's team compared the changes in the neutralizing ability of 20 neutralizing antibodies against Omicron, Omicron sublineages, and different mutation sites, suggesting that a large number of neutralizing antibodies are or have been "successfully escaped by the virus." The researchers said that although a few antibodies have not escaped, given the easy mutation characteristics of RNA viruses (the new coronavirus is an RNA virus), if it is used as a single therapy for a long time, drug resistance may occur.

Under this premise, small molecule anti-new coronavirus drugs are expected to be effective. Fortunately, more and more small molecule antiviral drugs have been proven to be effective against variants of the new coronavirus, such as Paciclovir, which has been approved for marketing, and VV116, which was reported today.

Source: Science and Technology Daily