A new drug by the Defence Research and Development Organisation (DRDO) has recently been approved for emergency use on Covid-19 patients by the Drugs Controller General of India (DCGI).
Developed by the Institute of Nuclear Medicine and Allied Sciences (INMAS), a lab of DRDO, in collaboration with Dr Reddy’s Laboratories, Hyderabad, this new drug called 2-DG (2-deoxy-D-glucose) helps Covid-19 patients recover faster and also reduces their dependence on medical oxygen (MO).
It is not a repurposed drug, and the way it has been manufactured is also unique. Reports claim that this drug selectively accumulates in infected cells and cuts off the energy supply to the virus. Therefore, the virus cannot multiply automatically, which helps in reducing the infection and the viral load gradually. Eventually, the cells recover.
The phase one and phase two trial results, based on which the emergency use authorisation has been granted by DCGI, obviously show a lot of promise. However, once the third phase trial reports are out, we will get a clearer picture of what is the risk-benefit analysis of this new drug.
The manufacturers of this drug claim that it is selectively taken up by infected cells only. However, it does not specify if this drug has the potential to kill some of the normal cells, or harm them, or has no impact on them whatsoever.
We will only know whether this drug has any side-effects when a trial is done on a larger population. Therefore, in the phase 3 trials, when the number of volunteers increases, we will understand better how this drug interacts with human cells.
While judging risks and benefits, the most significant thing is to evaluate if the benefits outweigh the risks. Currently, it is being administered to those who have moderate to severe Covid-19 infection. After using this drug, the probability of recovery in these patients is much higher than those put on standard care treatment. If, after the third phase trial too, this continues to be the case, and if there are no or minimal side-effects, then this drug will obviously help many patients.
The same is true for antiviral drugs and antibiotics that we commonly use. All these drugs have side-effects, they do affect normal cells, but the damage is much lesser than the benefit that we get out of them.
Broadly, you can classify 2-DG as an antiviral, but in the true sense, it is not an antiviral because it is not killing the virus. It only gets aggregated inside the cell and cuts off the growth material required for the virus to grow. In the classical sense, therefore, one cannot call it an antiviral.
Currently, the drug comes in powder form, in a sachet, which is taken orally by dissolving it in water. Since it has been approved for emergency use only, it has to be administered under supervised care. As per findings, a higher proportion of patients treated with the drug tested negative for Covid in RT-PCR tests.
Dr. Arun Sharma is the director of NIIRNCD (ICMR), Jodhpur.