Shionogi is in a race against Pfizer and Merck

Sneha Singhal, Jaypee Institute of information technology, Noida

Pfizer Inc. and Merck & Co. in the race to find treatments for Covid-19 have joined a Japanese company in starting human trials for the first once-daily pill. Shionogi and Co., of Osaka, claimed that its pill would neutralize the Coronavirus in five days or less. The company suggested dosing once a day. In a series of trials starting this month and continuing through next year, the company said it is testing the drug and its side effects. By the end of the year, Pfizer plans to commercialize a twice-daily pill. A study comparing the antiviral pill with a booster antiviral drug to placebo will enroll more than 2,000 patients. 

Aim of the companies:

To combat the pandemic, each company targets one of the biggest gaps. There is still clear efficacy of vaccines for preventing serious illness caused by Covid-19 virus strains, including the contagious Delta strain. Some people don’t want to get vaccinated, and despite getting their shots, cases can still occur. It is hoped that drugmakers can develop a pill that patients can take at home while they are still having mild symptoms, following a positive Covid-19 test.

Isao Teshirogi, Shionogi’s chief executive officer, emphasized the company’s objective of developing a safe oral compound similar to Tamiflu or Xofluza. Between 50 and 100 subjects will be enrolled in Shionogi’s upcoming trial in Japan. Later this year, a randomized study of the drug against a placebo in Covid-19 patients is expected to start in Japan.

Initial research showed the virus couldn’t easily mutate to escape Shionogi’s pill, Teshirogi reported. In April, Merck reported that its drug helped reduce viral load in Covid-19 patients, as well as the risk of hospitalization. Ebola treatment with this drug has been studied for years.

The race between these companies: 

Unlike Pfizer and Merck, Shionogi is still months behind Pfizer and Merck, which have already started testing pills to treat Covid-19 at a later stage. According to Teshirogi, Shionogi does not intend to limit drug tests to patients diagnosed recently. A drug company would likely partner with Shionogi to market the drug worldwide if the drug shows promise. The same thing occurred 20 years ago when Merck and Pfizer were gunning for their Japanese rival – this time for a prescription for cholesterol pills. Shionogi’s chemists found an alternative to Lipitor and Zocor, which were marketed worldwide by AstraZeneca PLC. 

However, some concerns over side effects such as muscle pain and cognitive impairment eventually did not deter Crestor from taking a significant share of the market. Doctors believe it helped lower the cholesterol levels of President Donald Trump during his tenure in office. Generic versions of Lipitor, Zocor, and Crestor are now available in the United States at a reasonable price.

Findings of different companies:

Infusions of Remdesivir by Gilead Sciences Inc. work sometimes and are typically administered in hospitals. Dexamethasone, an oral steroid made by Regeneron Pharmaceuticals Inc., is another option available to hospitalized patients. Currently, it is possible to purchase influenza medicines such as Roche Holding AG’s Tamiflu and Shionogi’s Xofluz, but these drugs do not work for everyone and might be prescribed too late. Roche markets Xofluza in the U.S. 

The Pfizer and Shionogi pills prevent virus replication inside human cells by inhibiting an enzyme and a protein known as protease. The virus that causes AIDS, HIV, is also commonly treated with protease inhibitors, but virus resistance is a concern. Daria Hazuda, at Merck’s Cambridge, said that if we do not take into account that in the HIV research, we would end up developing molecules that would quickly become outdated. 

Conclusion: 

Trials of drugs generally have a high failure rate. Taking covid-19 Pill at home may be impractical if there are any side effects, even one as mild and reversible as nausea. It is still unclear how eliminating the virus will affect serious complications like low oxygen levels. There are larger studies underway, focusing on patients with Covid-19 with risk factors for serious illness who have been diagnosed within the previous five days. Hazuda said that based on his experience so far with other interventions, the more we delay, the less likely we are to reap the benefits. 

Also read: Phenomics – Strategy for antiviral drug repurposing or discovery

Reference:

1. Covid-19 pill race heats up as Japanese firm vies with Pfizer, Merck. (2021, July 25).  The Wall Street Journal. https://www.foxbusiness.com/healthcare/covid-19-pill-race-heats-up-as-japanese-firm-vies-with-pfizer-merck

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