Simnotrelvir: New COVID-19 Pill With Significant Promise

A new medication for COVID-19 has recently been devleoped, and is much more affordable and accessible than its alternatives (Anthony Quintano, Wikimedia Commons)

Currently, the most common drugs used against COVID-19 in the U.S. are FDA-approved drugs such as Paxlovid and Veklury (Remdesivir). Despite these options, COVID-19 drugs are costly and thus not readily available for the average person seeking relief. Further, institutions such as the World Health Organization recommend only taking these drugs if you are a part of a high-risk group. “SARS-CoV-2 has already become a routine respiratory virus in general populations,” says study co-author Bin Cao, a pulmonologist at the China-Japan Friendship Hospital in Beijing. However, a new clinical trial shows hope with the successful results of a new COVID-19 drug: Simnotrelvir.

Current Treatments for COVID-19

Current treatments consist of Paxlovid and Veklury, both with many similarities. Paxlovid, a drug available to individuals over 12 years old and weighing over 88 pounds, is an oral antiviral taken at home to help keep high-risk patients from experiencing extreme symptoms. In clinical trials, it performed well, boasting an 89 percent reduction in the risk of hospitalization and death in unvaccinated people. It is also expected to work against the latest Omicron subvariants.

Veklury, another drug available to individuals over 12 years old and weighing over 88 pounds, is a drug only administered in hospital or healthcare settings. Veklury performed well in all three clinical trials before being FDA-approved. One randomized, double-blind, placebo-controlled clinical trial showed a difference of five days in the median time to recover from COVID-19. The group treated with Veklury had a median time to recover of 10 days, while the placebo group had 15 days. The other two clinical trials were randomized and demonstrated significant improvement in symptoms when the patients were treated with Veklury rather than just receiving standard care.

Although effective, these treatments have several drawbacks, primarily cost and availability. When looking at the cost, the manufacturer’s suggested retail price for Paxlovid is $1,390 per five-day course. Veklury remains expensive as well, with the typical cash price for Veklury being around $1,155.38 for a 100mg solution. Cost is not the only issue for Veklury, as it can only be administered in a hospital or healthcare setting, making accessibility to the drug harder for many individuals.

Introducing Simnotrelvir

On January 18, a new study in the New England Journal of Medicine published trial results of Simnotrelvir, an oral antiviral that can shorten the duration of mild to moderate COVID-19 symptoms. It has now been shown to speed recovery by about 1.5 days in patients with mild to moderate disease.

Clinical trials found that the drug kicked in almost immediately after being taken, relieving symptoms such as fever and cough. The study included ritonavir with the Simnotrelvir, acting like a booster to the antiviral. Out of the 1,208 patients in the study, 603 received Simnotrelvir, and 605 received the placebo. Patients treated with Simnotrelvir had, on average, 36 hours less of COVID-19 symptoms compared to the control group.

What’s Next?

At the moment, Simnotrelvir is only available in China. However, many experts predict that more drugs like Simnotrelvir will be approved in the U.S. by the end of 2024. Once approved, Simnotrelvir would solve many problems that Paxlovid and Veklury face, such as cost and accessibility, especially because it is a quarter of the price of Paxlovid and can be taken at home.