Revealed: How a single pill home-cure for Covid could be available this year

Trials of first pill specifically designed to stop SARS-CoV-2 are under way at 
Pfizer buildings in United States and Belgium

By Paul Nuki,  GLOBAL HEALTH SECURITY EDITOR, LONDON  24 April 2021
https://www.telegraph.co.uk/global-health/science-and-disease/revealed-home-cure-covid-could-available-year/


At two anonymous Pfizer buildings, one in the US and one in Belgium, remarkable 
experiments are now under way.

Up to 60 volunteers, all clean-living adults aged between 18 and 60, are being 
given the first pill specifically designed to stop SARS-CoV-2.

If the trial is successful, it is just possible that a home cure for Covid-19 
will become available later this year.

The Prime Minister, who announced the formation of a UK Antivirals Taskforce 
last week specifically to invest in such products, will no doubt be scanning 
his text messages for early updates.

The molecule being tested is a bespoke antiviral codenamed PF 07321332. Classed 
as a "protease inhibitor", it has been formulated to attack the "spine" of the 
SARS-Cov-2 virus and stop it replicating in our noses, throats and lungs.

It was protease inhibitors that turned the tide on the spread of HIV in the UK 
and around the world. Now researchers hope they may be on the brink of a 
similar pandemic-busting breakthrough.

"If they have moved to this stage, they will be quietly optimistic," said Prof 
Penny Ward, visiting professor in pharmaceutical medicine at King's College 
London and a pioneer in the development of Tamiflu, an antiviral that combats 
seasonal and pandemic flu.

"The question will be about how the drug is tolerated... They will be going 
like the clappers."

The anti-viral pill was developed from scratch during the current pandemic, 
Dafydd Owen, the director of medicinal chemistry at Pfizer, told a private 
symposium of the Division of Medicinal Chemistry last month.

The first seven milligrams of the compound – no more than a raindrop – were 
made in late July. By late October, they had made 100 grams of the drug. Just 
two weeks later, they had more than a kilogram in the bag. It took 210 
researchers to do it, said Owen.

Pfizer is keeping schtum about the detail of the lab tests it has completed but 
says it has demonstrated "potent in vitro antiviral activity against 
SARS-CoV-2" as well as activity against other coronaviruses, raising the 
prospect of cure to the common cold as well as future pandemic threats.

"We have designed PF-07321332 as a potential oral therapy that could be 
prescribed at the first sign of infection, without requiring that patients are 
hospitalized or in critical care,"said Mikael Dolsten, chief scientific officer 
and president, worldwide research, development and medical of Pfizer in an 
official statement.

According to Prof Ward, Pfizer's scientists will have most likely established 
the drug's "potent"” action against SARS-CoV-2 by deploying it against infected 
human tissue cultures, including lung tissue, in a laboratory.  "Once you know 
it works in vitro, it's all about establishing its tolerance in animals and 
then humans," she said.

The Telegraph has obtained copies of the documents given to participants who 
are now entering the first human trials.

"To date, the study drug has not been administered to humans", say the 
documents, which were formally approved on Feb 8. "The safety of the study drug 
has been studied in animals. In these animal studies, no significant risks or 
safety events of concern were identified, and the study drug did not cause 
side-effects at any of the dose levels that will be used in clinical studies."

Those who have signed up for the trial are in for an intensive few months. The 
trial is split into three phases and will run for 145 days, with another 28 
days added for "screening and dosing". For all participants, there will be 
several overnight stays.

"You are here today as a possible participant in a drug research study 
sponsored by Pfizer Incorporated," say the briefing documents. "Taking part in 
this study is voluntary (your choice)... If you are not completely honest about 
your health history, you may be harmed by being in this study."

The "randomized, double-blind, placebo-controlled, single- and multiple-dose 
escalation study" is designed to see how well or otherwise different dosing 
regimens are tolerated in humans while the active compound is maintained in the 
body.

PF-07321332 will be administered in combination with low doses of Ritonavir, an 
antiviral used to treat HIV. It acts as a "booster" to increase the amount of 
PF-07321332 in participants' blood.

Phase 1 of the trial is designed to see how it "is tolerated as the dose is 
increased, alone or with ritonavir, if there are significant side effects, and 
how people feel after taking it", say the documents.

Phase 2 will do the same but with "multiple doses", while in Phase 3, tablet 
and liquid forms of the drug will be tested, as will the impact of eating on 
top of it.

Every detail has been specified in advance. In Phase 3, for example, a high-fat 
breakfast is defined as: "Two eggs fried in butter, two strips of pork bacon, 
two slices of toast with butter, 4 oz. of hash brown potatoes, and 8 oz. of 
whole milk.... eaten in 20 minutes".

Bringing a new drug to market is a long and difficult process, and even if 
PF-07321332 is found to be well tolerated in humans, formal Phase 3 trials 
would need to follow to establish whether the drug worked against people 
exposed to SARS-CoV-2.

Prof Ward has also warned of more practical problems. The antiviral Tamiflu 
that she helped create costs about £25 a course and is still not widely 
prescribed in the UK against seasonal flu because of its price tag, despite 
some 20,000 people dying of the disease in Britain each year.

For Pfizer and PF-07321332, it is a "race against time", she said. They not 
only need to produce a drug that works but need to do it while SARS-CoV- 2 
still presents a major public health threat.

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