Covid, what happened to the antivirals
Antivirals against Covid are little used. Here is a possible explanation and the data of the latest Aifa monitoring
It was thought that it was all the fault of the bureaucracy , of the slow and convoluted procedures and, instead, the antivirals against Covid – Pfizer's Paxlovid, in particular, as more effective – are still used very little according to the latest monitoring carried out by the Italian Medicines Agency (Aifa) in the period 1-7 June.
A MORE LEAN BUT INSUFFICIENT PROCEDURE
Paxlovid to be effective must be taken within 5 days of the onset of symptoms and until recently it was not enough for a patient to go to the pharmacy with the prescription, but had to be referred by his doctor to a hospital pharmacy or specialized hospital centers. .
However, to receive this antiviral you must be at least 18 years old, not HIV positive and not suffering from severe renal and hepatic impairment. Furthermore, the patient must present at least one important pathology which, combined with the virus, could lead to a serious evolution of the disease.
Aifa includes people with 'active' cancer, chronic renal failure, severe pulmonary disease, primary or acquired immunodeficiency, obesity, heart failure, coronary artery disease, cardiomyopathy and uncompensated diabetes mellitus.
USE OF PAXLOVID
Despite the simplifications in the procedure, Paxlovid continues to be little prescribed by doctors. Since the start of monitoring (January 2022), Pfizer's anti-Covid pill, which also showed 88% efficacy against Omicron, has only been administered to 17,839 people.
Italy has purchased 600,000 treatments.
Always considering the week 2-8 June, regional differences persist, from Lazio which prescribes more than all (83 requests), followed by Lombardy (67) to Basilicata (3), Umbria (1) and the autonomous provinces of Bolzano ( 1) and Trento (0) which close the ranking.
WHY WE DON'T USE IT?
It is hypothesized that, in addition to the fact that the requirements for receiving Paxlovid are very stringent, the little use is also due to the type of cases that tested positive for the swab recorded in recent months.
This was supported by Pier Luigi Bartoletti, Deputy National Deputy Secretary of the Italian Federation of General Practitioners (Fimmg) and Provincial Secretary of Fimmg Rome: "At least here – he explained to Quotidiano Sanità – until the beginning of last week they received a positive swab mostly young and healthy people, therefore not suitable to receive Paxlovid, or the very elderly. However, many of these had a complicated health picture with many comorbidities. Treatment with Paxlovid would have made it necessary to suspend all other therapies for at least a week. From the point of view of the risk / benefit ratio, it was therefore preferred not to prescribe the antiviral but to opt for the use of monoclonal antibodies ".
SOMETHING IS CHANGING?
However, according to Bartoletti, cases are changing, in fact to Quotidiano Sanità he declared: “In less than a week – from last Wednesday to today – I have already made 8 prescriptions for Paxlovid. Now, when no one expected it, cases are rapidly increasing and the average age of positives is rising. The trend is on the rise. We have a problem related to the fact that this is a much more widespread variant ”.
The expert defends Italy's choice of optioning 600,000 treatments, which he considers “prudential and correct” because “I had never seen a respiratory virus that with 35 degrees in the shade circulates in this way. This virus has taught us that we must always stay one step ahead ".
THE OTHER ANTIVIRALS: MOLNUPIRAVIR AND REMDESIVIR
Of the 50,000 purchased doses of Molnupiravir, Merck's antiviral, Italy has used 29,535 treatments so far. Its effectiveness, however, stops at 30%.
As for Remdesivir, an antiviral that requires hospitalization because it is administered intravenously, 10,815 treatments were used.
This is a machine translation from Italian language of a post published on Start Magazine at the URL https://www.startmag.it/sanita/covid-che-fine-hanno-fatto-gli-antivirali/ on Wed, 22 Jun 2022 13:16:18 +0000.