Someone asked me to keep a list of drugs which looked like they would work against COVID. Wikipedia has a list, a bit outdated. I plan to do more work on this in the future.
These are certainly good:
- Dexamethasone, 17% mortality reduction
- IL-6 blockers, 24% mortality reduction on top of dexamethasone
- Remdesivir (AKA Veklury), injected. There was some controversy about its effectiveness, especially given its cost, but a more recent study found it cut the chance of going on a ventilator by half.
- Mono- or poly-clonal antibodies:
- Bamlanivimab (LY-CoV555) plus Etesevimab (LY-CoV016) (together) — monoclonal antibodies (co-developed by Vancouver company AbCellera!} reduced hospitalization/death by 85%-87%. Unfortunately, it takes an infusion, which is a PITA to administer. They do not work against Omicron.
- Sotrovimab (VIR7831) from GSK (which this article and says still works well against Omicron! This preprint says it has slightly reduced efficiency against Omicron.)
- Casirivimab plus imdevimab (REGEN-COV from Regeneron) — does not work against Omicron.
- Tixagevimab (AZD1061) and cilgavimab (AZD8895) (in combination named Evusheld from AZ, AKA AZD7442), approved by the US FDA on 10 Dec 2021. This preprint says that neither neutralize Omicron, but this press release says that Evusheld does neutralize Omicron.
- DXP-604, a Chinese monoclonal antibody, works at a reduced level against Omicron.
- BRII-196 is in phase 2 trials.
- Oral therapies:
- Pfizer’s Paxlovid, a protease inhibitor, is 89% effective against severe disease. Probably will cost ~US$500 per treatment course. It was approved for emergency use in the EU on 2021-12-16, in the USA on 2021-12-22, and in Canada on 2022-01-17.
- Marck’s molnupiravir (trade name Lagevrio) is 30% effective against severe disease (originally it was 50%, but I guess they redid their calculations or somethign). It works by mutating the virus to death. Approved 4 November by the UK. Probably will cost ~US$700 per treatment course.
- Preliminary results for Novartis’ ensovibep say that it’s 78% effective at preventing hospitalization.
These might be good:
- peginterferon lambda
- tocilizumab — One study said it was good, another study said it was not. The editors tried to figure out why.
- inhaled budesonide — one study says that it reduces hospitalization, fever, recovery period
- amodiaquine (an antimalarial) shows good results in hamsters
- ADG20, a monoclonal antibody
These have been proven to be unhelpful:
- Convalescent plasma
- Colchicine — old drug for gout, sometimes used for cardiac issues — not statistically significant. This very large RECOVERY study shows it doesn’t help.
Fluvoxamineis a selective serotonin reuptake inhibitor, cheap (~US$10 per course of treatment), and already approved (for depression). It looked good in initial studies, but a larger study found no benefit. Ivermectin– Suppresses COVID in vitro, but at levels higher than are approved in humans. In vivo studies have not yet shown that it helps.
- Vitamin D – There are a lot of small studies which show that Vitamin D is really useful (or perhaps that Vitamin D deficiency — which is very common — is really bad if you catch COVID). Larger studies are underway but have not yet proved anything.