Clazakizumab for COVID-19

Context: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first identified in Wuhan, China. From the outset, this highly contagious and dangerous illness posed significant risks and challenges for global healthcare systems and populations. Scientists and healthcare professionals worldwide have been striving to develop effective treatments for severe acute respiratory SARS-CoV-2 infection, employing both pre-existing and innovative approaches. However, a specific drug targeted explicitly against COVID-19 remains elusive. Despite the reduced prevalence of severe cases and the predominance of the SARS-CoV-2 Omicron variant, COVID-19 continues to pose significant risks, particularly for polymorbid patient groups. This review focuses on the potential antiviral effects of promising new drugs, including ensitrelvir, clazakizumab, upamostat, and others. Evidence Acquisition: An analytical review was conducted using the Scopus, PubMed, EMBASE, ScienceDirect, and Google Scholar databases for publications related to promising drugs against SARS-CoV-2, their mechanisms of action, and potential therapeutic effects up to November 2024. Selection criteria included: (1) Free-text availability; (2) English language; (3) relevance to the publication's theme a total of 104 articles were initially selected. Of these, 27 articles were excluded for not meeting the free-text criterion, 14 were excluded due to language incompatibility, and 28 were excluded for thematic irrelevance. Ultimately, data from 35 articles were analyzed and summarized for this review. Results: Thirty-five scientific studies were reviewed to describe current paradigms and emerging concepts in SARS-CoV-2 treatment. Current drugs with proven efficacy include: (1) Combined monoclonal antibodies targeting the S-protein (casirivimab/imdevimab); (2) monoclonal antibody preparations against the S-protein (pemivibart; vilobelimab); (3) viral replication inhibitors (molnupiravir); (4) protease inhibitors (nirmatrelvir/ritonavir); (5) immunosuppressants (dexamethasone; tocilizumab). The review also highlights drugs under development targeting traditional pathways [e.g., viral protease, interleukin-6 (IL-6)] and those aimed at novel mechanisms (e.g., antigalectin-3; adhesion blockers). Conclusions: Although numerous drug effects and potential drug combinations for COVID-19 have been described, limited clinical trials and research focus on identifying novel treatment approaches. Comprehensive investigations are needed to assess and evaluate the risks of different treatment strategies, minimizing potential short- and long-term complications for patients. Such advancements will pave the way for more optimal and effective medical treatment of COVID-19.

According to the World Health Organization (WHO), in the second half of 2022, there are about 606 million confirmed cases of COVID-19 and almost 6,500,000 deaths around the world. A pandemic was declared by the WHO in March 2020 when the new coronavirus spread around the world. The short time between the first cases in Wuhan and the declaration of a pandemic initiated the search for ways to stop the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or to attempt to cure the disease COVID-19. More than ever, research groups are developing vaccines, drugs, and immunobiological compounds, and they are even trying to repurpose drugs in an increasing number of clinical trials. There are great expectations regarding the vaccine’s effectiveness for the prevention of COVID-19. However, producing sufficient doses of vaccines for the entire population and SARS-CoV-2 variants are challenges for pharmaceutical industries. On the contrary, efforts have been made to create different vaccines with different approaches so that they can be used by the entire population. Here, we summarize about 8162 clinical trials, showing a greater number of drug clinical trials in Europe and the United States and less clinical trials in low-income countries. Promising results about the use of new drugs and drug repositioning, monoclonal antibodies, convalescent plasma, and mesenchymal stem cells to control viral infection/replication or the hyper-inflammatory response to the new coronavirus bring hope to treat the disease.