More on Covid-19

MUMBAI: Mumbai-based drug major Cipla , credited with several innovations especially in respiratory and flu therapy, could well become one of the first domestic companies to roll out new drugs for the coronavirus . The company is both fast-tracking development of these drugs with government laboratories, and repurposing its wide portfolio of respiratory, asthma, anti-virals and HIV drugs to meet challenges arising from Covid-19 in India.“We consider it a nationalistic duty to put all our resources to benefit the country,” Cipla promoter Yusuf Hamied told TOI in an exclusive interview. He added the company is doubling production of these therapies. Cipla already distributes Swiss company Roche’s anti-inflammatory drug Actemra in India, which can be used in patients with severe lung problems, he added, listing other respiratory therapies which can be used, if the medical fraternity decides.This assumes significance as Cipla’s strength in respiratory, anti-flu and HIV drugs is well-established, as all three are believed to be effective in the present situation, though there is not enough data at present to establish them as treatments.Cipla, instrumental in making healthcare affordable by launching copies of AIDS, cancer and other life-saving drugs in the past, was also one of the first companies to launch generic treatment for H1N1 influenza in recent years. Significantly, Actemra, used in rheumatoid arthritis, has been approved by China recently for patients with severe complications of Covid-19, while Roche is initiating trials to evaluate its safety and efficacy in hospitalised patients with severe Covid-19 pneumonia in the first such global study.At present, there is no treatment for Covid-19. While clinical data on HIV, anti-virals, and anti-malarials for treating coronavirus patients is yet to be established, with over 10,000 deaths globally, experimental drugs and combinations are being used.Elaborating on new drugs, Hamied said development of promising anti-viral compounds — favipiravir, remidesivir and bolaxavir, will be initiated to treat Covid-19. “We are looking into how to produce raw materials (active pharmaceutical ingredients) with the help of government laboratories for these drugs,” he said, adding, it will take six months to launch after procurement of raw materials.The coronavirus mainly infects lungs, and the company has a range of asthma drugs including Foracort, Seroflo, Duolin and Aerocort and certain nebuliser respules to treat asthma, which can be used as supplements, he said. (A respule is a small plastic container that contains a liquid, which is put into a machine called a nebuliser for treating asthma and other respiratory diseases).“We have a wide range in our portfolio — we do not know what medicine/combination will work. It is the doctor’s discretion,” he said. Drugs which have shown promise, and are now part of a global trial, include antiviral drug remedesivir, a combination of two HIV drugs, lopinavir and ritonavir; lopinavir and ritonavir plus interferon beta; and antimalarial drug chloroquine.Cipla already manufactures Lopimune tablets, a combination of lopinavir and ritonavir, and is keenly watching the developments. Earlier, the Drug Controller General had approved the ‘restricted use’ of a combination of anti-HIV drugs for treating those affected by Covid-19, after ICMR sought an emergency approval for the use of ‘lopinavir’ and ‘ritonavir’ combinations.On the availability of these critical drugs, Hamied said, “We have enough in India right now. But if it becomes a cluster or community transmission, then it could be a problem. We are worried about the uncertainty (of the virus and its spread)”. The US has just approved the use of anti-malarial drug chloroquine as a treatment, while France is studying a combination of hydroxychloroquine, a popular anti-malaria drug, and antibiotic azithromycin. Both are plenty in India, Hamied said. The company is working closely with the government including Indian Council of Medical Research director general Balram Bhargava, Drugs Controller General V G Somani, and Indian Institute of Chemical Technology scientists.