Two studies find SARS-CoV-2 virus becoming resistant to antiviral drugs used to treat patients

[nec209]

Two studies find SARS-CoV-2 virus becoming resistant to antiviral drugs used to treat patients

Two studies have found that the virus that causes COVID-19 is becoming resistant to two drugs used to treat patients with infections.

As part of that effort, two such therapies, named remdesivir and nirmatrelvir, have become the go-to drugs for patients with immune systems that are not capable of fighting off the virus. But because they are antivirals, they run the risk of obsolescence as the virus mutates.

https://medicalxpress.com/news/2024-09-sars-cov-virus-resistant-antiviral.html

================

 

It is strange how first two years of the pandemic there was lots of talk into anti viral drugs and now there is no talk at all.

I just check wikipedia under treatment every month and I don’t see any new anti viral drugs. Not even experimental drugs and treatments.

Has founding for covid really dried up now?

 

[studiot]

25 minutes ago, nec209 said:

Two studies find SARS-CoV-2 virus becoming resistant to antiviral drugs used to treat patients

Two studies have found that the virus that causes COVID-19 is becoming resistant to two drugs used to treat patients with infections.

As part of that effort, two such therapies, named remdesivir and nirmatrelvir, have become the go-to drugs for patients with immune systems that are not capable of fighting off the virus. But because they are antivirals, they run the risk of obsolescence as the virus mutates.

https://medicalxpress.com/news/2024-09-sars-cov-virus-resistant-antiviral.html

================

 

It is strange how first two years of the pandemic there was lots of talk into anti viral drugs and now there is no talk at all.

I just check wikipedia under treatment every month and I don’t see any new anti viral drugs. Not even experimental drugs and treatments.

Has founding for covid really dried up now?

 

Is this fake news for disruption purposes ?

 

Remdesivir is still the treatment of choice in the UK

 

https://www.nhs.uk/medicines/remdesivir-veklury/how-and-when-to-have-remdesivir/

 

Perhaps @CharonY can advise us reliably ?

Edited November 3 by studiot

[exchemist]

49 minutes ago, nec209 said:

Two studies find SARS-CoV-2 virus becoming resistant to antiviral drugs used to treat patients

Two studies have found that the virus that causes COVID-19 is becoming resistant to two drugs used to treat patients with infections.

As part of that effort, two such therapies, named remdesivir and nirmatrelvir, have become the go-to drugs for patients with immune systems that are not capable of fighting off the virus. But because they are antivirals, they run the risk of obsolescence as the virus mutates.

https://medicalxpress.com/news/2024-09-sars-cov-virus-resistant-antiviral.html

================

 

It is strange how first two years of the pandemic there was lots of talk into anti viral drugs and now there is no talk at all.

I just check wikipedia under treatment every month and I don’t see any new anti viral drugs. Not even experimental drugs and treatments.

Has founding for covid really dried up now?

 

Is the text highlighted in blue your own words or are you quoting someone else, and if so what is the source?

I'm not sure it is strange. There may well be work on further antivirals but such work, now that there is no longer a global health emergency, would not be expected to result in regular updates in Wikipedia.

I had a quick look on the web and found this review from Jan 2023 : https://pharmaceutical-journal.com/article/feature/next-generation-antivirals-targeting-covid-19. which explains the challenges and refers to next generation antiviral approaches. So it's clear that a fair amount of research was in progress at that time. What has happened since I do not know.  

But don't forget that antivirals are not vaccines. The mainstay of the public health approach to covid remains vaccination. Antivirals are only a last resort, used to help the immunocompromised or others that become very ill for some reason.  

 

 

[nec209]

5 minutes ago, exchemist said:

Is the text highlighted in blue your own words or are you quoting someone else, and if so what is the source?

I'm not sure it is strange. There may well be work on further antivirals but such work, now that there is no longer a global health emergency, would not be expected to result in regular updates in Wikipedia.

I had a quick look on the web and found this review from Jan 2023 : https://pharmaceutical-journal.com/article/feature/next-generation-antivirals-targeting-covid-19. which explains the challenges and refers to next generation antiviral approaches. So it's clear that a fair amount of research was in progress at that time. What has happened since I do not know.  

But don't forget that antivirals are not vaccines. The mainstay of the public health approach to covid remains vaccination. Antivirals are only a last resort, used to help the immunocompromised or others that become very ill for some reason.  

 

 

I tried to post second post to not confuse what I found on the internet but it will not allow me so I highlight it blue.

What do you mean that second generation anti viral drugs are harder to make?

[exchemist]

3 hours ago, nec209 said:

I tried to post second post to not confuse what I found on the internet but it will not allow me so I highlight it blue.

What do you mean that second generation anti viral drugs are harder to make?

I did not say that. 

[nec209]

11 minutes ago, exchemist said:

I did not say that. 

You posted.

Quote

which explains the challenges and refers to next generation antiviral approaches

The link you posted shows it harder to make second generation drugs.

[swansont]

2 hours ago, nec209 said:

The link you posted shows it harder to make second generation drugs.

You should quote the relevant passage. The link discusses making drugs with fewer side effects and fewer conflicts with other medications. Is that it? It’s not that it’s second generation, per se, it’s that you’re adding constraints to the task. Constraints that weren't considered in the effort to get something available because people were dying, and the process takes time.

[exchemist]

8 hours ago, nec209 said:

You posted.

The link you posted shows it harder to make second generation drugs.

Does it? I read it, admittedly rather quickly, as explaining the issue of resistance and the limitations of any antiviral approach. That applies to the first antivirals just as much as subsequent ones.
 

That is what the article, not I, seems to be saying. I most certainly did not say 2nd generation antivirals are harder to make than 1st generation ones.

[CharonY]

I looked at the Nature paper and one thing that seems to get lost in the conversation is that the study specifically looked at immunocompromised patients with chronic infections. The reason why that is important is because that in those folks infections stick around longer so mutations can arise which could be selected for higher resistance against antivirals. It is not something that is unknown (similar effects have been observed for antibiotic resistances) and it is not a failure of the drug.

 

The second study actually seems to contradict what the article in OP is saying. Again, higher rate in immunosuppressed patients and lower rate of resistance in treated patients without immune issues (but still higher than without treatment). However, rates were low and did not persist. So overall good news, though again, immunocompromised patients remain at higher risk.

[studiot]

1 hour ago, CharonY said:

I looked at the Nature paper and one thing that seems to get lost in the conversation is that the study specifically looked at immunocompromised patients with chronic infections. The reason why that is important is because that in those folks infections stick around longer so mutations can arise which could be selected for higher resistance against antivirals. It is not something that is unknown (similar effects have been observed for antibiotic resistances) and it is not a failure of the drug.

 

The second study actually seems to contradict what the article in OP is saying. Again, higher rate in immunosuppressed patients and lower rate of resistance in treated patients without immune issues. However, rates were low and did not persist. So overall good news, though again, immunocompromised patients remain at higher risk.

thanks for that expert opinion. +1

[CharonY]

I probably should add that any treatment likely provides selective pressures in favour of mutations that provide drug resistance (if applicable). No drug is likely safe from that effect. The key here is not to provide a situation where the pathogens are allowed to persist under selective pressures. This is why antibiotics should be taken at high dosages and until the pathogen are eliminated, otherwise, one allows the more resistant ones to proliferate.

This is also why vaccines are so important. If a pathogen, such as SARS-CoV-2 is allowed to circulate, it will accumulate mutations just by virtue of so much of it being around, which in turn makes it more likely that we encounter resistant variants. Breaking the chain of infections, or at least reducing it, as well as reducing the amount of serious infections, so that antivirals are not necessary is is the only way to delay resistance formation. 

It was always weird to me that there are folks against vaccines, but in favour of antivirals. 

 

[nec209]

On 11/4/2024 at 2:34 AM, exchemist said:

Does it? I read it, admittedly rather quickly, as explaining the issue of resistance and the limitations of any antiviral approach. That applies to the first antivirals just as much as subsequent ones.
 

That is what the article, not I, seems to be saying. I most certainly did not say 2nd generation antivirals are harder to make than 1st generation ones.

If you look at Wikipedia Nirmatrelvir and Remdesivir are older drugs that came out in 2020 the same with Paxlovid. They both have side effects so I can see the article why they are talking about newer drugs.

So if it not harder to make second generation drugs than why was it so fast to bring out first generation drugs and there is no second generation drugs now.

 

[exchemist]

20 minutes ago, nec209 said:

If you look at Wikipedia Nirmatrelvir and Remdesivir are older drugs that came out in 2020 the same with Paxlovid. They both have side effects so I can see the article why they are talking about newer drugs.

So if it not harder to make second generation drugs than why was it so fast to bring out first generation drugs and there is no second generation drugs now.

 

Because, as I say, we are not any longer in the middle of a global health emergency involving a largely unknown virus. We have a largely vaccinated population, our medical services are under a lot less pressure and we know a great deal more about the virus. So we can take our time and try to get better antivirals more deliberately than we could in the initial rush to get something out that worked.

[CharonY]

14 minutes ago, exchemist said:

Because, as I say, we are not any longer in the middle of a global health emergency involving a largely unknown virus. We have a largely vaccinated population, our medical services are under a lot less pressure and we know a great deal more about the virus. So we can take our time and try to get better antivirals more deliberately than we could in the initial rush to get something out that worked.

Much of it is just a matter of public money. Remdesivir for example was originally developed to treat other viruses but I am not sure how far in trials it actually went. Trials for COVID-19 were possible by a huge injection of governmental money (over 160 millions or so).

Oftentimes it is not just a matter of harder easier or more deliberate. It is often how much the companies are willing to invest. Ideally, if they don't have to, things can go pretty fast (until there are roadblocks for scientific reasons, that is). There are quite a few new generation of antiviral candidates. However, getting them to clinicals is the most expensive bit and unless the companies can make money, they wont' commit that much. This either means that clinicals can take a long time to finish, or might not finish at all.

[exchemist]

14 minutes ago, CharonY said:

Much of it is just a matter of public money. Remdesivir for example was originally developed to treat other viruses but I am not sure how far in trials it actually went. Trials for COVID-19 were possible by a huge injection of governmental money (over 160 millions or so).

Oftentimes it is not just a matter of harder easier or more deliberate. It is often how much the companies are willing to invest. Ideally, if they don't have to, things can go pretty fast (until there are roadblocks for scientific reasons, that is). There are quite a few new generation of antiviral candidates. However, getting them to clinicals is the most expensive bit and unless the companies can make money, they wont' commit that much. This either means that clinicals can take a long time to finish, or might not finish at all.

Sure. So in other words, we have now reverted to “normal” after the pandemic and no longer feel the need to divert huge sums of public money into crash development programmes, trials and so forth. From the article, I gained the impression that further antivirals can be expected in due time, no doubt stimulated by the emergence of the drug resistance referred to.

[CharonY]

5 minutes ago, exchemist said:

Sure. So in other words, we have now reverted to “normal” after the pandemic and no longer feel the need to divert huge sums of public money into crash development programmes, trials and so forth. From the article, I gained the impression that further antivirals can be expected in due time, no doubt stimulated by the emergence of the drug resistance referred to.

Potentially. It really depends on how the market develop and/or whether health authorities see a heightened need. Our understanding of postviral syndromes has accelerated by having so many people suffer from it, for example, so I would consider the situation still developing. But as you said, not in an emergency context.

[nec209]

54 minutes ago, exchemist said:

Because, as I say, we are not any longer in the middle of a global health emergency involving a largely unknown virus. We have a largely vaccinated population, our medical services are under a lot less pressure and we know a great deal more about the virus. So we can take our time and try to get better antivirals more deliberately than we could in the initial rush to get something out that worked.

Well is the money drying up now? Are countries today spending money on drugs and treatment for Covid?

Is the US spending millions or billions each year on Covid?

 

[exchemist]

53 minutes ago, nec209 said:

Well is the money drying up now? Are countries today spending money on drugs and treatment for Covid?

Is the US spending millions or billions each year on Covid?

 

Yes of course money continues to be spent on covid countermeasures. I very much doubt if billions of public money is being spent on them in the USA. But drug companies will be sending a fair bit I expect, in the expectation that many countries' health systems will continue to need a pipeline of antivirals for a long time to come.

[CharonY]

7 minutes ago, exchemist said:

Yes of course money continues to be spent on covid countermeasures. I very much doubt if billions of public money is being spent on them in the USA. But drug companies will be sending a fair bit I expect, in the expectation that many countries' health systems will continue to need a pipeline of antivirals for a long time to come.

There is still some, including academic and commercial research. There is also a bit of redistribution to other diseases that have taken a backburner until recently. But I don't know how much precisely. But I do think that there are still a few millions specifically for COVID-19 for sure.