Despite various drug development efforts, only vaccines led by AstraZeneca, Pfizer-BioNTech, Moderna, and more recently Sputnik V have been approved for the management of COVID-19. Efforts towards drug treatment of COVID-19 are still ongoing. That notwithstanding, several drug molecules including drugs already approved for other diseases are emerging as providing benefits for the treatment of COVID-19 patients.
Between October 2020 to date, Sars-CoV-2 has manifested in three different variants from the original virus for which some vaccines were produced. These mutations include B.1.1351(501Y.V2) from South Africa, 501Y.V3 in Brazil, and B.1.1.7 (501Y.V1) from the United Kingdom. Following the higher transmissible nature of N501Y mutation familiar to all these variants from South Africa, Brazil, and the UK, the projected impact of vaccines needs revision since highly transmissible variants lead to exponential growth in the number of infections. This calls for consideration of alternative drug development avenues aside from vaccines.
Some drug molecules such as Pyronaridine, synthesized in 1970 at the Institute of Chinese Parasitic Disease have been used in China for over 30 years for the treatment of malaria. Pyronaridine was approved as an orphan drug for the management of Ebola in different parts of the world and is showing promise in the fight against COVID-19 due to its antiviral properties.
Pyronaridine in combination with Artesunate (Pyramax, an oral drug) is a World Health Organization (WHO) prequalified Artemisinin-based Combination Therapy for the treatment of malaria and registered in Ghana for the treatment of uncomplicated malaria.
Pyramax (Artesunate-Pyronaridine), a fixed-dose combination medication for the treatment of malaria, has been approved for clinical trials in South Korea to compare and evaluate its efficacy and safety in treating patients infected with the coronavirus. The primary purpose and outcome of the trial is the treatment of mild to moderate covid-19 infection and viral clearance (negative nasal swab) on Day 7. In addition, it is also being tried in South Africa, Kenya, and Burkina Faso to pick African efficacy data. The study is being led by the Liverpool School of Hygiene and Tropical Medicine.
In vitro studies comparing pyronaridine, artesunate and hydroxychloroquine against SARS-COV-2 show that pyronaridine-artesunate is more potent than hydroxychloroquine in the human lung epithelial cell line. Artesunate, on the other hand, has similar antiviral properties and offers anti-inflammatory effects which suggest its potential usefulness in the treatment of COVID-19. The Estimated Study Completion date is September 30, 2021.
In 2017, Pyramax an oral drug produced as a result of a collaboration between Medicines for Malaria Venture (MMV), University of Iowa, and Shin Poong Pharm, a South Korean pharmaceutical firm specializing in neglected tropical diseases, was included in both the pediatric and adult Essential Medicines Lists of WHO for the treatment of uncomplicated malaria. To enhance accessibility in Low- and Middle-Income Countries, the Global Fund has also included Pyramax in its list of drugs.
Internationally, Pyramax is registered in twenty-six countries with high malaria burden and locally registered by the Ghana Food and Drugs Authority since March 2020 for the management of uncomplicated malaria.
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