Future Implications
Currently, two treatment options for SARS-CoV-2 are being extensively
studied; molnupiravir and monoclonal antibodies (mAbs)
(bamlanivimab–etesevimab, casirivimab–imdevimab, and sotrovimab) and
both of these agents have shown promising results. [19,20] In
trials, mAbs have been shown to reduce the risk of hospitalization, and
death and have also demonstrated virological benefit by reducing the
viral load. Similar results were seen with molnupiravir in the MOVE-OUT
trial. However, molnupiravir being an oral drug would be more convenient
for use as compared to mAbs. mAbs require intravenous infusion and thus
can only be administered in the presence of trained medical personnel.
mAbs are an expensive class of drugs and therefore their availability in
countries with fewer resources might also be an issue. Furthermore, the
efficacy of mAbs against the changing variants is also in doubt because
these drugs work by binding to the spike proteins on SARS-CoV-2, and
mutations in the spike proteins might affect their potency. Moreover,
molnupiravir work by targeting the RdRp of the virus and is thus
independent of mutations in the spike proteins.
Future trials should comprise of large sample sizes so a more robust
idea about the dangers and potency of molnupiravir in Covid-19 positive
patients could be achieved.
Conclusion: In our meta-analysis, we conclude that molnupiravir
is most effective in treating SARS-COV-2 patients with respect to
eliminating the virus from the host through their mechanism of action.
Thereby, widely used and appropriate to treat SARS-COV-2. The results
demonstrate the efficacy of molnupiravir in the hierarchy of dosages
administered. The 800mg is more potent to create viral RNA error rate,
likewise the 400mg dose. Furthermore, for mean change in SARS-COV-2 RNA
viral load in the nasopharyngeal sample from baseline is also
significant for 800mg and 400mg molnupiravir. However, none of the 200mg
molnupiravir holds efficacy in reducing or altering the viral RNA to
treat the patients of SARS-COV-2. Similarly, the promising result of
400mg molnupiravir reduces the incidence of death in SARS-COV-2
patients. Thereby the outcome depicts that molnupiravir could be a
potential treatment for SARS-COV-2 patients.
Disclosure: None
Conflict of interest: None