Pfizer has applied for FDA emergency use of its COVID-19 pill, known as Paxlovid, in high-risk outpatients; the drug combines a novel antiviral with HIV-treatment ritonavir, cutting the risk of hospitalization and death by 89%, the company says. (CNBC)
In other good news for Pfizer, the FDA reportedly plans to authorize use of the company’s booster shot for all adults as early as Thursday; multiple states have already started doing so already. (New York Times)
Meanwhile South Korea is looking to cut the interval for boosters to 4 months amid a spike in serious COVID-19 cases among vulnerable populations. (Reuters)
The Biden administration is planning to spend billions of dollars on the manufacturing of at least 1 billion COVID-19 vaccine doses annually for overseas and domestic use. (New York Times)
After declines during most of the fall, COVID-19 cases in the U.S. are starting to climb ahead of the holidays. (NPR)
As of Wednesday at 8 a.m. ET, the unofficial U.S. COVID toll reached 47,312,411 cases and 765,919 deaths, up 89,511 cases and 1,492 deaths from this time a day ago.
I have a major concern about issuing booster and/or 3rd, 4th shots of initial mRNA vaccines to boost Monoclonal Neutralizing Antibodies ( MNABs) based upon initial virus when new studies funded by NIH Gov raise concerns over Delta and Lambda strains escaping MNABs protection generated from these vaccines.
Lopinavir+ritonavir = Paxlovid?
Lopinavir (Kaletra) is potent anti-HIV drug that is used to treat HIV infection in combination with ritonavir. Ritonavir inhibits the drug metabolism of lopinavir to improve the PK (half-life) and activity. Infectious Diseases Society of America (IDSA) recommended ritonavir-boosted combination therapy for HCV patients as first line therapy30. Lopinavir/ritonavir have shown anti SARS-CoV-2 activity in vitro by inhibiting the protease in Vero E6 cells31. In a comparative study32, lopinavir-ritonavir in combination with ribavirin exhibited a risk in SARS-CoV. Moreover, SARS patients disclosed that Lopinavir-ritonavir plays an important role to explain the clinical consequences and in combination with IFN enhanced clinical outcomes on some MERS patients33. Lopinavir-ritonavir was found to provide a
40% decrease in the risk of MERS infection34. In India, EMR division has advised the dosing schedule for this drug combination for clinical management of COVID-1935. One randomized open-label clinical trial36 for lopinavir-ritonavir is conducted on 199 patients, of whom 99 were appointed to the treatment group, and 100 received the standard of care. The authors did not find more advantage of lopinavir-ritonavir to clinical benefits beyond the standard of care, while it was found to have benefit for some secondary endpoints. The efficacy of the lopinavir-ritonavir was approved, and future trials will verify the results36. Currently, 64 clinical trials are proceeding for lopinavir-ritonavir along with other drug involvements, and the majority of them are at the initial stage of the progress37.
Lopinavir and Ritonavir are both zinc ionophores and found in the Zinc pharmaceutical database.