The Central government hasn’t included antiviral drug Molnupiravir in its revised clinical guidance for management of adult COVID-19 patients, and specified that Remdesivir and Tocilizumab should be prescribed under certain conditions only.
It stated that high-risk for severe disease or mortality is among those over 60 years. Also people with cardiovascular disease, hypertension, diabetes mellitus and other immunocompromised states (such as HIV), active tuberculosis, chronic lung/kidney/liver disease, cerebrovascular disease and obesity fall in this category.
The guidelines were revised by the All India Institute of Medical Science and Indian Council of Medical Research (ICMR)-COVID-19 National Task Force/ Joint Monitoring Group, under the Health Ministry
Molnupiravir had previously received a thumbs down from the ICMR even after it got approval for emergency use by the Drugs Controller General of India (DCGI). ICMR Director General Dr. Balram Bharagava had raised safety concerns about the drug.
New drugs
Meanwhile, the World Health Organisation on January 14 added new drugs Baricitinib and Sotrovimab for treatment of COVID-19 patients. It noted that Baricitinib is recommended for treating those suffering with severe or critical COVID-19 and Sotrovimab , a monoclonal antibody drug, is recommended for treating patients who have mild or moderate COVID-19.
Speaking about the use and availability of these drugs in India, Dr. Gopi Krishna Yedlapati, consultant interventional pulmonologist, Yashoda Hospitals, Hyderabad, said Sotrovimab, a synthetic antibody, was not available in the country. “The other drugs which we used are predominantly anti-inflammatory drugs such as steroids, Toclizumab, Baricitinib, etc., of which Baricitinib has proven its efficacy in controlling the disease effectively. But before initiating Baricitinib, we have to be careful that the patient doesn’t have any other bacterial infection and should be necessarily on blood thinners,” he stated, adding that Baricitinib had been used effectively in most of their patients.
Dr. Manoj Goel, director, Pulmonology, Fortis Memorial Research Institute, observed Baricitinib was being used in serious patients along with steroids. “Baricitinib is almost equally effective as the other comparator drug, Tocilizumab, with the added advantage of being more economical and orally available. Sotrovimab is another monoclonal cocktail therapy, which is effective against Omicron and recommended for high-risk patients to prevent serious disease. This drug is not yet available in India,’’ he pointed out.
