Covid, are antivirals being used? And how?
Aifa has foreseen the use of a monitoring registry for both antivirals, but that of remdesivir is reserved only for doctors and pharmacists and that of molnupiravir is not yet available.
Italy has a higher number of Covid deaths than other European states and it is not just because we are the second oldest country in the world. For Stefania Salmaso, epidemiologist and former director of the National Epidemiology Center of the Higher Institute of Health (ISS), one of the causes lies precisely in not using all the tools available enough, from antivirals to technology to collect more information.
WHAT SALMASO SAID
"We should have more information, know the comorbidities, the timing of hospitalization, eligibility for therapeutic treatments, in short, if there is room for improvement in the terrible load of fatal cases daily," said Salmaso in an interview with La Stampa .
Speaking of the growing number of daily deaths attributed to Covid, the epidemiologist added: “There could be some inefficiency in the health system, I am thinking for example of the quantification of the amount preventable with antivirals within five days of infection. While vaccines are offered to everyone, these drugs are at risk of inequality and we need a campaign on the issue involving general practitioners ”.
CONTINUOUS UPDATE
Professor Evelina Tacconelli also referred to the importance of continually updating despite the workload accumulated by all medical staff in the last two years, speaking of the scarce use that Italy makes of monoclonals.
“Apart from the difficulty of rapidly producing the scientific evidence necessary for therapeutic guidelines, it is also a problem of medical culture. The doctors themselves, subjected to massive work stress, did not find the correct time for appropriate information and this is certainly understandable ”, he told Avvenire .
“But Italy already had a basic problem: compared to other countries, continuous medical updating is not consistently organized and is too often left in the hands of the pharmaceutical industries. It is very serious, because what we studied during university is only an infinitesimal portion of what is possible today, and without a permanent update we can make very serious mistakes. For example, – continues Tacconelli – much of the information on anti Covid-19 therapies to date has not reached the medical population, I am thinking of Chloroquine and Azithromycin, drugs that at the beginning of the epidemic seemed to be useful, then they were checked. in global studies conducted according to all the rules of evidence that have clearly demonstrated their uselessness, indeed perhaps a risk for the patient who takes them ”.
WHICH ANTIVIRALS ARE EFFECTIVE AGAINST OMICRON
But there is no doubt about the antivirals. "Oral and intravenous antivirals such as paxlovid and remdesivir retain their efficacy against the Omicron variant and may help limit the disease burden associated with this variant," said Marco Cavaleri, head of vaccination strategy at the European Medicines Agency ( Ema).
Oral antivirals such as paxlovid and molnupiravir, and intravenous ones such as remdesivir, are indicated for patients with mild or moderate disease and at risk of developing severe disease.
It is important to administer them as soon as the first symptoms appear: in the case of molnupiravir within 5 days, while remdesivir can be used up to 7 days after the onset of symptoms.
The Italian Medicines Agency (Aifa) has foreseen the use of a monitoring register for both antivirals, however, that of remdesivir is reserved only for doctors and pharmacists and that of molnupiravir is not yet available .
HOW MANY ANTI-COVID PILLS DO THE REGIONS HAVE?
As Start wrote a few days ago, Italy has so far received 11,899 packs of 40 tablets. The treatments were divided as follows between the various regions: Abruzzo 360 packs, Basilicata 60, Calabria 120, Campania 480, Emilia Romagna 840, Friuli Venezia Giulia 240, Lazio 1,680, Liguria 1,080, Lombardy 1,800, Marche 600, Molise 60, Piedmont 739, Autonomous Province of Bolzano 60, Autonomous Province of Trento 60, Puglia 240, Sardinia 60, Sicily 360, Tuscany 1,440, Umbria 60, to Valle d'Aosta 120, to Veneto 1,440.
THE COMBINATION OF ANTIVIRALS WITH MONOCLONALS
Lazio, Liguria and Piedmont began administering the first doses of molnupiravir a few days ago and in the Marche, in addition to having prescribed them, the Marche Nord hospital has launched an experimental program that provides "for positive patients who go to the emergency room outpatient treatment with monoclonal antibodies and remdesivir ”, said the councilor for health Filippo Saltamartini. Patients must go to the clinic or hospital for three consecutive days without any hospitalization.
"A recent study published by the New England Journal of Medicine – added the commissioner – shows that administered in this way the drug produces an 80% reduction in the evolution of the disease and hospitalization".
This is a machine translation from Italian language of a post published on Start Magazine at the URL https://www.startmag.it/sanita/covid-si-stanno-usando-gli-antivirali-e-come/ on Thu, 13 Jan 2022 14:55:21 +0000.