Antiviral Molnupiravir Reduces Risk of Hospitalization/Death by ~50 Percent • Hacker News Board

Re: Antiviral Molnupiravir Reduces Risk of Hospitalization/Death by ~50 Percent

#161

Post by avianlyric » Fri, Oct 01, 2021, 6:47 PM UTC

jrockway wrote: post #107

photochemsyn wrote: post #55

Some interesting points on the nature of our pharmaceutical patent system... (and while the cohort in this study does seem a bit small, the conclusions appear to be fairly valid): > "Molnupiravir was invented at Drug Innovations at Emory (DRIVE), LLC, a not-for-profit biotechnology company wholly owned by Emory University, and is being developed by Merck & Co., Inc. in collaboration with Ridgeback Biotherapeutics." >…

I don't think investing money necessarily transfers the ownership of things bought with that money to the investor. The government could put in their contract "we get all your drugs that you invent" if they wanted that. But this would be like startup VCs getting 100% of your company, or your bank getting the appreciation on your house when you sell it, etc. They could ask for those things, and you could say no... and…

Even the VCs get a better deal here, they end up with equity. If followed that model, then the taxpayer would own at least 50% of the patents generated (via shares the corporate entity that owned the patents).

Under the current model the taxpayer gets nothing, which hardly seems reasonable given the amount of capital they provide.

Re: Antiviral Molnupiravir Reduces Risk of Hospitalization/Death by ~50 Percent

#162

Post by barbazoo » Fri, Oct 01, 2021, 6:50 PM UTC

Disclaimer: I'm not promoting Ivermectin here, don't get me wrong. I just want to cover my bases as this announcement is definitely going to be used by people to support their conspiracy theory.

Earlier this year Merck the manufacturer of Ivermectin issued this [0] statement saying that Ivermectin isn't useful for preventing/treating Covid-19 and people shouldn't take it. Some people explained that with the fact that Ivermectin is cheap and they want to develop a more expensive option. I didn't take this seriously, just another conspiracy theory. But now they are coming out with a $1000 per dose solution. According to the FDA [1], the use of Ivermectin for Covid-19 is still being studied and they refer to ongoing trials. Now some people with actual subject matter expertise will know more than me but afaik we haven't completely ruled out Ivermectin for the treatment/prevention of Covid-19, have we? If not, could there be some truth to the allegations that Merck somehow is stalling the Ivermectin studies?

[0] https://www.merck.com/news/merck-statement-on-ivermectin-use...

[1] https://www.fda.gov/consumers/consumer-updates/why-you-shoul...

Re: Antiviral Molnupiravir Reduces Risk of Hospitalization/Death by ~50 Percent

#163

Post by shrubble » Fri, Oct 01, 2021, 6:51 PM UTC

smnrchrds wrote: post #39

mmastrac wrote: post #7

Earlier quoted context omitted.

If it halves hospitalizations, it'll have a pretty drastic effect on overwhelmed ICUs but there's probably still a ways to go before ICU levels return to normal and we can skip mandates.

Alberta has 173 normal ICU beds. As of this Monday, there were 312 Albertans in ICUs, 265 of whom for COVID [1]. The extra 139 beds were surge capacity, created by shutting down other services, postponing surgeries, and diverting resources to COVID ICU treatments. Even if the number of COVID patients in ICUs halved, we would have 132 people in the ICU with COVID, or 179 patients in total for all causes. It would stil…

Alberta has 4.4 mln or so people.

Colorado, with 5.8 mln people, has over 1700 ICU beds.

Alberta's been 'running on fumes' re: ICU beds and they got caught out...

Re: Antiviral Molnupiravir Reduces Risk of Hospitalization/Death by ~50 Percent

#164

Post by bshoemaker » Fri, Oct 01, 2021, 6:54 PM UTC

barbazoo wrote: post #162

Disclaimer: I'm not promoting Ivermectin here, don't get me wrong. I just want to cover my bases as this announcement is definitely going to be used by people to support their conspiracy theory. Earlier this year Merck the manufacturer of Ivermectin issued this [0] statement saying that Ivermectin isn't useful for preventing/treating Covid-19 and people shouldn't take it. Some people explained that with the fact that…

Is there any evidence they are?

Otherwise, that sounds like a conspiracy theory itself.

Re: Antiviral Molnupiravir Reduces Risk of Hospitalization/Death by ~50 Percent

#165

Post by rsynnott » Fri, Oct 01, 2021, 6:54 PM UTC

rory wrote: post #86

lsternlicht wrote: post #43

Phase 3 trial was stopped on a positive interim analysis by DSMB and in consultation with FDA Interim analysis was performed on approximately half of the total enrolled patients (775 of the 1550). Trial included many delta and other variant patients ————— Efficacy • ~50% reduction in hospitalization (14.1% PBO vs 7.3% drug) • 100% reduction in deaths (8 PBO vs 0 drug) ————— Safety • fewer adverse reactions in the dru…

Is 40% adverse reaction to a placebo typical? Really makes me wonder how many "side effects" are in our heads..

Given that this is a drug that's only given to people who _have covid_, I'd say it's incredibly difficult to disambiguate from covid symptoms.

Re: Antiviral Molnupiravir Reduces Risk of Hospitalization/Death by ~50 Percent

#166

Post by kortex » Fri, Oct 01, 2021, 6:55 PM UTC

WaitWaitWha wrote: post #56

This is not my field. But if there is a pill that can reduce death by 50% from the virus, I would like to know more about it. > Bright's concerns that similar drugs in its class have mutagenic properties As a layperson, this instantly raises a red flag in my mind. Should I be concerned? Why, or why not? More importantly, where can I find research that elucidates this for me?

Molnupiravir, being a polymerase inhibitor (in layman's terms it "jams up replication machinery"), has the potential for mutagenicity. In fact it was dropped by a Gilead subsidiary for this exact reason. [1]

> A company called Pharmasset Inc. (a hepatitis C drugmaker Gilead bought in 2011) investigated molnupiravir’s main ingredient around the turn of the century, but it abandoned development over concerns that it was mutagenic, meaning it could lead to birth defects.

Actually the article is slightly wrong, mutagenic is causing mutations in the host's germ or somatic DNA, teratogenic is causing birth defects. Most mutagens are teratogens too. From the Dr Bright complaint filing, Bright was concerned about reproductive toxicity (teratogenicity) so I'm not sure if the article meant to say teratogenic, or the concern is that the drug is both mutagenic and teratogenic (polymerase drugs tend to be both).

Subsequent tests seem to have shown a lack of mutagenic activity in hosts (eg Painter 2021), at least enough to get through safety trials, which is excellent. But looking at it from a structural activity point of view, molnupiravir is way, way more likely to have a DNA-affecting mechanism than mRNA. It has also shown mutagenic effect in vitro [2]. Nonetheless, a small increase in cancer risk years down the road (especially in the over-70 crowd) is likely worth the 50% (!) reduction in mortality.

It's probably fine, as long as you aren't pregnant. Like all drugs, it's about risk/benefit ratio. The covid vaccine has a much more favorable profile and should still be the preferred option. I doubt it'll be approved for pregnant women without a reproductive toxicity study.

1 - https://www.bloomberg.com/news/features/2021-03-25/merck-mrk...

2 - https://pesquisa.bvsalud.org/global-literature-on-novel-coro...

Search for 'β-D-N4-hydroxycytidine safety' if you wanna dig deep.

Re: Antiviral Molnupiravir Reduces Risk of Hospitalization/Death by ~50 Percent

#167

Post by barbazoo » Fri, Oct 01, 2021, 6:59 PM UTC

bshoemaker wrote: post #164

barbazoo wrote: post #162

Disclaimer: I'm not promoting Ivermectin here, don't get me wrong. I just want to cover my bases as this announcement is definitely going to be used by people to support their conspiracy theory. Earlier this year Merck the manufacturer of Ivermectin issued this [0] statement saying that Ivermectin isn't useful for preventing/treating Covid-19 and people shouldn't take it. Some people explained that with the fact that…

Is there any evidence they are? Otherwise, that sounds like a conspiracy theory itself.

Not that I know if. I'm a layman I know pretty much nothing in that field so I'm just having a hard time dismissing the whole Ivermectin thing. Especially now that Merck will make a boatload of money with their new drug.

If I was Merck and I had a drug #1 that costs a few cents that might work and I can develop a new drug #2 that will cost $1000, then I'd probably not look into #1 much simply for financial reasons.

That might not be how it works but I simply don't know that.

Re: Antiviral Molnupiravir Reduces Risk of Hospitalization/Death by ~50 Percent

#168

Post by akira2501 » Fri, Oct 01, 2021, 6:59 PM UTC

jrockway wrote: post #107

photochemsyn wrote: post #55

Some interesting points on the nature of our pharmaceutical patent system... (and while the cohort in this study does seem a bit small, the conclusions appear to be fairly valid): > "Molnupiravir was invented at Drug Innovations at Emory (DRIVE), LLC, a not-for-profit biotechnology company wholly owned by Emory University, and is being developed by Merck & Co., Inc. in collaboration with Ridgeback Biotherapeutics." >…

I don't think investing money necessarily transfers the ownership of things bought with that money to the investor. The government could put in their contract "we get all your drugs that you invent" if they wanted that. But this would be like startup VCs getting 100% of your company, or your bank getting the appreciation on your house when you sell it, etc. They could ask for those things, and you could say no... and…

> The government could put in their contract "we get all your drugs that you invent" if they wanted that.

"The government" isn't an entity that can unilaterally decide anything. I think it's incredibly revealing that very little of this process is understood or publicized.

Re: Antiviral Molnupiravir Reduces Risk of Hospitalization/Death by ~50 Percent

#169

Post by [deleted] » Fri, Oct 01, 2021, 6:59 PM UTC

[deleted] wrote: post #104

carbocation wrote: post #37

I think it's disappointing that this thread has devolved into a political discussion that is hardly related to the topic. The scientific/medical achievement here seems significant. As an MD, the difference between calling in a script for a pill and arranging for outpatient infusion therapies is vast.

[deleted]

[deleted]

Re: Antiviral Molnupiravir Reduces Risk of Hospitalization/Death by ~50 Percent

#170

Post by BobbyJo » Fri, Oct 01, 2021, 7:00 PM UTC

avianlyric wrote: post #161

jrockway wrote: post #107

Earlier quoted context omitted.

I don't think investing money necessarily transfers the ownership of things bought with that money to the investor. The government could put in their contract "we get all your drugs that you invent" if they wanted that. But this would be like startup VCs getting 100% of your company, or your bank getting the appreciation on your house when you sell it, etc. They could ask for those things, and you could say no... and…

Even the VCs get a better deal here, they end up with equity. If followed that model, then the taxpayer would own at least 50% of the patents generated (via shares the corporate entity that owned the patents). Under the current model the taxpayer gets nothing, which hardly seems reasonable given the amount of capital they provide.

Don't we already own a portion of what gets created though? If Merck makes a boatload of money off of this, the taxpayers will indeed be taking a cut.