Deccan Chronicle

Is Covid-19 treatment based on trial and error?

With due respect and regard for our doctors and frontline workers who have risked their life in treating patients, there are doubts, unanswered questions on the treatment given to covid patients — some lost their life, many survivors are faced with dread

- SWATI SHARMA DECCAN CHRONICLE

As the number of COVID-19 cases in India soar, so does informatio­n (and misinforma­tion) about the treatment protocols, adding to the strain, confusion and feeling of helplessne­ss among patients and caregivers.

There are many contradict­ing views. Questions have been raised about combinatio­ns of repurposed and experiment­al medicines recommende­d by healthcare practition­ers as a one-size-fits-all solution.

Researcher­s, medical practition­ers, and citizens have been debating if the over-prescripti­on of drugs is responsibl­e for the rising health complicati­ons among COVID-19 patients.

Top-notch doctors address the many issues people are raising on the pros and cons of various

treatment options.

It’s been over a year since COVID-19 was declared a pandemic, but the world is still trying to find ways to conquer it. The second wave has been more destructiv­e than the first one. Many lives have been lost.

The disease is new, the virus itself seems to be evolving, and so is the knowledge about it, and consequent­ly, the best ways of handling it can only be arrived at by a process of trial, and possibly, error.

Researcher­s, medical practition­ers, and citizens have been debating if the over-prescripti­on of drugs is responsibl­e for the rising health complicati­ons among COVID-19 patients.

An overall look at the situation indicates that doctors are prescribin­g up to a dozen medicines for even mild cases of COVID-19; antibiotic­s like azithromyc­in and doxycyclin­e are being commonly advised despite significan­t clinical trials having found no evidence of their efficacy; the World Health Organizati­on (WHO) has cautioned that there is no evidence to suggest that the antiviral drug Remdesivir is useful in treating hospitalis­ed COVID-19 patients; Plasma therapy has been dropped as a treatment for the disease after a Government panel found it ‘ineffectiv­e’; and drugs that have proven benefits in managing the infection are often prescribed at inappropri­ate clinical stages of the disease – for instance, steroids like dexamethas­one and methylpred­nisolone benefit only patients with moderate to severe COVID-19, but many doctors prescribe them for patients with mild infections.

MONOCLONAL ANTIBODY THERAPY – PROVEN EFFICACY

“Many things are clear now. The therapy scientific­ally proven to be most effective is the use of monoclonal antibodies within seven days of disease onset. This is used only for mild and moderate cases of COVID-19, and prevents these cases from turning severe. It is found effective even on patients above 65 years and those who have diabetes, or kidney and cardiac problems,” says Dr D Nageshwar Reddy, Chairman of the Asian Institute of Gastroente­rology and AIG Hospitals.

Lately, 2-DG, a dru oped by India’s Research Developmen­t Organ (DRDO), has been in th as a possible savi

COVID-19 infections. Talking about the pr endorsemen­t, Dr G. S Reddy, DRDO, chie

“Phase-2 trials were d

110 patients from May Oct 2020. Safety was v establishe­d and verifie independen­t DSM Efficacy was found to highly significan­t in Based on these highly aging results, DCGI g mission for Phase-3

Phase-3 trials were don patients from Novemb to May 2021 in 27 h throughout the countr has given Emergen Authorisat­ion for its adjunct therapy in mod severe covid patients.”

Sudhir Chandna, Scientist INMAS Additional Director explains that “the p efficacy endpoint analy shown that 42% of p treated with 2-DG plu dard care were able to of oxygen dependence, pared to 31% patients

An overall look at the situation indicates that doctors are prescribin­g up to a dozen medicines for even mild cases of COVID-19; antibiotic­s like azithromyc­in and

doxycyclin­e are being commonly advised despite significan­t clinical trials having found no evidence of their

efficacy

Chief

and DRDO, primary ysis has patients us stano be free , as comin standard

Chief Scientist INMAS and Additional Director DRDO

care.” He adds that patients with controlled diabetes were among those enrolled in the trial of the prescribed dose (45 mg/kg twice a day), and the drug was found to be safe in these patients too. “Uncontroll­ed diabetics were

excluded from the trials, and the drug is not recommende­d for them,” he cautions.

Giving his views on treatment option, Nageshwar Reddy says, “2DG is potentiall­y a good drug in patients who this

Dr require oxygen. It is an old drug used for cancer patients, where the cells divide rapidly.”

 ??  ?? Dr Viswesvara­n Balasubram­anian Senior Interventi­onal Pulmonolog­ist and Sleep Medicine Specialist, Yashoda Hospitals
Dr Viswesvara­n Balasubram­anian Senior Interventi­onal Pulmonolog­ist and Sleep Medicine Specialist, Yashoda Hospitals
 ??  ?? Sudhir Chandna
Chief Scientist INMAS and Additional Director, DRDO
Sudhir Chandna Chief Scientist INMAS and Additional Director, DRDO
 ??  ?? Dr D Nageshwar Reddy
Chairman of the Asian Institute of Gastroente­rology and AIG Hospitals
Dr D Nageshwar Reddy Chairman of the Asian Institute of Gastroente­rology and AIG Hospitals
 ??  ?? Dr Kasu Prasad Reddy
Chief Surgeon, Founder & Mentor MaxiVision Eye Hospitals Group
Dr Kasu Prasad Reddy Chief Surgeon, Founder & Mentor MaxiVision Eye Hospitals Group
 ??  ?? Dr Shankara Chetty General Practition­er in South Africa
Dr Shankara Chetty General Practition­er in South Africa
 ??  ?? Chief, Defence Research and Developmen­t Organisati­on (DRDO)
Chief, Defence Research and Developmen­t Organisati­on (DRDO)
 ??  ?? Dr G. Satheesh Reddy
Dr G. Satheesh Reddy
 ?? 2-DG — A GAME-CHANG ??
2-DG — A GAME-CHANG
 ??  ??
 ??  ?? GER?
ug develDefen­ce
and nisation he news iour in
rocess of Satheesh f, says done on y 2020 to ery well ed by an Board. be very
Phase-2. encourave per3 trial. ne on 220 ber 2020 hospitals ry. DCGI cy Use
use as derate to “The primary efficacy endpoint analysis has shown that 42% of patients treated with 2-DG plus standard care were able to be free of oxygen dependence. Patients with controlled diabetes were among those enrolled in the trial of the prescribed dose (45 mg/kg twice a day), and the drug was found to be safe. Uncontroll­ed diabetics were excluded from the trials, and the drug is not recommende­d for them.”
— SUDHIR CHANDNA,
GER? ug develDefen­ce and nisation he news iour in rocess of Satheesh f, says done on y 2020 to ery well ed by an Board. be very Phase-2. encourave per3 trial. ne on 220 ber 2020 hospitals ry. DCGI cy Use use as derate to “The primary efficacy endpoint analysis has shown that 42% of patients treated with 2-DG plus standard care were able to be free of oxygen dependence. Patients with controlled diabetes were among those enrolled in the trial of the prescribed dose (45 mg/kg twice a day), and the drug was found to be safe. Uncontroll­ed diabetics were excluded from the trials, and the drug is not recommende­d for them.” — SUDHIR CHANDNA,
 ??  ?? “Phase-2 trials were done on 110 patients from May 2020 to Oct 2020. Safety was very well establishe­d and verified by an independen­t DSM Board. Efficacy was found to be very highly significan­t in Phase-2. Based on these highly encouragin­g results, DCGI gave permission for Phase-3 trial. DCGI has given Emergency Use Authorisat­ion for its use as adjunct therapy in moderate to severe covid patients.”
“Phase-2 trials were done on 110 patients from May 2020 to Oct 2020. Safety was very well establishe­d and verified by an independen­t DSM Board. Efficacy was found to be very highly significan­t in Phase-2. Based on these highly encouragin­g results, DCGI gave permission for Phase-3 trial. DCGI has given Emergency Use Authorisat­ion for its use as adjunct therapy in moderate to severe covid patients.”
 ??  ??

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