During a video conference with the states on Friday, the ICMR said that Remdesivir and tocilizumab, used as investigational therapies, should be used strictly as they can cause adverse side effects on other body parts, including the liver and kidney.
As we all know that no vaccine for COVID-19 has been produced so far, doctors and researchers from all over the world are testing some existing drugs to treat this viral infection. One of these few drugs is Remdesivir, originally known as an antiviral drug, and was created to treat Ebola.
In some studies, it has been suggested that Remdesivir may reduce the time required for clinical improvement in more than normal and severe cases of the corona. Based on these studies, the Drug Controller General of India (DCGI) approved Remdesivir for restricted emergency use on critically ill hospitalized coronavirus patients. India’s three pharma companies Cipla, Hetero and Mylan NV, were also approved by the Drug Authority to manufacture and sell generic versions of Remdesivir.
But now, the government has advised caution on the use of Remdesivir injectable formulations. The Indian Council of Medical Research (ICMR) and the All India Institute of Medical Sciences (AIIMS) have asked states to use Remdesivir with extreme caution. Its indiscriminate use or excessive use is causing more harm to the body rather than benefiting it. Both ICMR and AIIMS have also warned against the use of tocilizumab. This drug is also necessary for the treatment of corona patients, who have difficulty in breathing.
Adverse Effects Can Occur from Remdesivir
The ICMR states that available evidence for Remdesivir suggests that it may reduce the time required for clinical improvement in severe and more frequent cases of the corona. Still, no benefit has been seen in terms of decreased mortality. The Ministry of Health said in a statement on Saturday that studies like Remedisvir do not show any benefit from tocilizumab for the reduction in corona deaths.
The ministry further stated that all investigational treatments should only be performed inappropriate health care facilities where close monitoring of patients is possible so that potential complications can be managed.
Guidelines on Clinical Management
As there is no cure for COVID-19, yet, the mode of treatment for the disease is largely based on supportive care. The ICMR stated that clinical management should remain focused on oxygen therapy, steroids (which are widely available and inexpensive). Along with this, and the timely administration of anti-coagulants and high-quality supportive care, mental health counselling for patients and families should also include management of pre-existing disease and symptom aversion.
During the video conference, ICMR and AIIMS asked states to follow the standard of care treatment for mild, moderate, and severe cases described in the Clinical Management Protocol of the Ministry of Health.
For moderate and severe cases, adequate oxygen support, appropriate and timely administration of anti-coagulants and widely available and inexpensive corticosteroids may be considered the mainstay of corona therapy. For mild cases, which account for about 80 per cent of the total cases, doctors have been advised to use hydroxychloroquine (HCQS).
According to the Ministry of Health, the standard of care treatment strategies have shown positive results.