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How remdesivir can save lives in nations with lower hospital capacity

The mortality rate for Covid-19 in ICUs varies from country to country and hospital to hospital, so the number of lives saved from increased ICU capacity would also vary, the study said.

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New York, July 8 : Amid news that the US has bought up virtually the entire global supply of remdesivir, a new study outlines how the drug could save lives in countries with a lower hospital capacity, such as South Africa, where Covid-19 is beginning to overwhelm intensive care units (ICUs).

The study, published in the journal Clinical Infectious Diseases, estimated that remdesivir”s ability to shorten ICU stays could increase the number of patients treated in South Africa”s ICUs by more than 50 per cent.

“There are many countries with limited ICU capacity that could benefit from this double impact on mortality,” says study lead author Dr Brooke Nichols, Assistant Professor at the Boston University.

For the remdesivir study, the research team used their South African National Covid-19 Epidemiology model to look at the estimated three to six months when severe cases will exceed the country”s 3,450 available ICU beds. If every one of South Africa”s ICU patients with Covid-19 received remdesivir, reducing the average ICU stay, the researchers estimated that the number of patients treated in ICUs from June to December would increase from between 23,443 and 32,284 patients to between 36,383 and 47,820.

The findings showed that the increased capacity of remdesivir could save as many as 6,862 lives per month as the country”s cases peak and the drug could prevent the deaths of as many as 13,647 South Africans by December.

The mortality rate for Covid-19 in ICUs varies from country to country and hospital to hospital, so the number of lives saved from increased ICU capacity would also vary, the study said.

The research team has been modelling South Africa”s Covid epidemic to help the country”s government make informed decisions, and previously predicted that the country”s ICU capacity could be overwhelmed as early as this month. “The hardest-hit province, the Western Cape, exceeded ICU capacity in June,” the study authors informed.

Earlier this month, the European Commission had authorised anti-viral drug remdesivir for the treatment against coronavirus, making it the first drug authorised at the European Union level for the treatment of Covid-19.

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Male sex hormones may help treat breast cancer: Study

While endocrine therapy is standard-of-care for estrogen receptor positive breast cancer, resistance to these drugs is the major cause of breast cancer mortality.

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Sydney : Researchers have found new evidence about the positive role of androgens, commonly thought of as male sex hormones but also found at lower levels in women, in breast cancer treatment.

In normal breast development, estrogen stimulates and androgen inhibits growth at puberty and throughout adult life.

Abnormal estrogen activity is responsible for the majority of breast cancers, but the role of androgen activity in this disease has been controversial.

The new research published in the journal Nature Medicine showed that androgens have potential for treatment of estrogen receptor positive breast cancer.

A cancer is called estrogen receptor positive if it has receptors for estrogen, according to Breastcancer.org.

Using cell-line and patient-derived models, the global team, including researchers at the University of Adelaide and the Garvan Institute of Medical Research in Australia, demonstrated that androgen receptor activation by natural androgen or a new androgenic drug had potent anti-tumour activity in all estrogen receptor positive breast cancers, even those resistant to current standard-of-care treatments.

In contrast, androgen receptor inhibitors had no effect.

“This work has immediate implications for women with metastatic estrogen receptor positive breast cancer, including those resistant to current forms of endocrine therapy,” said lead researcher Theresa Hickey, Associate Professor at the University of Adelaide.

“We provide compelling new experimental evidence that androgen receptor stimulating drugs can be more effective than existing (e.g. Tamoxifen) or new (e.g. Palbociclib) standard-of-care treatments and, in the case of the latter, can be combined to enhance growth inhibition,” said Wayne Tilley, Director of the Dame Roma Mitchell Cancer Research Laboratories, Adelaide Medical School, University of Adelaide.

Androgens were historically used to treat breast cancer, but knowledge of hormone receptors in breast tissue was rudimentary at the time and the treatment’s efficacy misunderstood.

Androgen therapy was discontinued due to virilising side effects and the advent of anti-estrogenic endocrine therapies.

While endocrine therapy is standard-of-care for estrogen receptor positive breast cancer, resistance to these drugs is the major cause of breast cancer mortality.

“The new insights from this study should clarify the widespread confusion over the role of the androgen receptor in estrogen receptor driven breast cancer,” said Elgene Lim, a breast oncologist and Head of the Connie Johnson Breast Cancer Research Lab at the Garvan Institute.

“Given the efficacy of this treatment strategy at multiple stages of disease in our study, we hope to translate these findings into clinical trials as a new class of endocrine therapy for breast cancer.”

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Expert panel recommends Phase 1 trial of nasal Covid-19 vaccine

According to the firm, an intranasal vaccine stimulates a broad immune response at the site of infection, in the nasal mucosa, which is essential for blocking both infection and transmission of Covid-19.

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New Delhi, Jan 20: The Subject Expert Committee (SEC) of the Central Drugs Standard Control Organisation (CDSCO) on Tuesday recommended Bharat Biotech’s intranasal vaccine for coronavirus for phase 1 clinical trials. The final call will now be taken by the Drugs Controller General of India.

Days after getting the Drugs Controller General of India’s nod for restricted emergency use of India’s first indigenously-made coronavirus vaccine, Bharat Biotech had applied to the drug regulator for permission to start the clinical trials of their nasal coronavirus vaccine.

The nasal vaccine is different from the intramuscular vaccine which recently got approval, as it is non-invasive, needle-free, doesn’t require trained healthcare workers, eliminates needle-associated risks, suits children and adults and has scalable manufacturing.

Earlier on Tuesday, Dr VK Paul, Member, NITI (National Institution for Transforming India) Aayog had said, “A nasal vaccine candidate has been identified. It has come for consideration for phase 1 and phase 2 trials. If it works then it could be a game-changer.”

“Phase 1 has been recommended,” top government sources told IANS. Clinical trials of Bharat Biotech’s ‘BBV154’ — a novel adenovirus vectored, and intranasal vaccine for coronavirus — will be conducted at various locations. The vaccine will be single-dosed.

According to the firm, an intranasal vaccine stimulates a broad immune response at the site of infection, in the nasal mucosa, which is essential for blocking both infection and transmission of Covid-19.

The vaccine has demonstrated protective efficacy in mice and hamsters. Mice and hamsters immunized with its single-dose conferred superior protection against the SARS-CoV-2 challenge, “more so than one or two intramuscular immunizations of the same vaccine and dose.”

“Thus, intranasal immunization of ChAd-SARS-CoV-2-S can create an immune response in the nose, which is the point of entry for the virus, thereby protecting against disease, infection and transmission,” Bharat Biotech said in a statement.

On January 3, two intramuscular vaccines – Bharat Biotech’s Covaxin and Oxford-AstraZeneca’s Covishield manufactured by the Serum Institute of India were approved for restricted emergency use and have been administered to over four lakh people till now. Both are two-dose vaccines.

While the full efficacy of Covaxin is yet to be determined, it was given the go-ahead by the DCGI citing ‘public interest’. Covaxin is an indigenously developed vaccine by Bharat Biotech, in collaboration with the Indian Council of Medical Research (ICMR).

Public health experts believe that intranasal vaccines for coronavirus, administered through the nose rather than muscles, can be a potential game-changer in India’s fight against the coronavirus pandemic.

Last month, Pune-based Serum Institute of India and Codagenix Inc had announced that they have received regulatory approval in the United Kingdom to begin an early-stage trial of their single-dose, intranasal coronavirus vaccine.

(Aakanksha Khajuria can be contacted at [email protected])

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Covid-19 vax: WHO warns of ‘catastrophic moral failure’

He said over 39 million vaccine doses had been given in 49 richer states – but one poor nation had only 25 doses.

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Geneva, Jan 19 : The world faces a “catastrophic moral failure” because of unequal Covid-19 vaccine policies, the head of the World Health Organization (WHO) has warned.

WHO chief Tedros Adhanom Ghebreyesus said it was not fair for younger, healthy people in richer nations to get injections before vulnerable people in poorer states, the BBC reported.

He said over 39 million vaccine doses had been given in 49 richer states – but one poor nation had only 25 doses.

Meanwhile, both the WHO and China were criticised for their Covid response.

An independent panel commissioned by the WHO said the UN public health body should have declared an international emergency earlier, and also rapped China for not taking public health measures sooner.

So far, China, India, Russia, the UK and the US have all developed Covid vaccines, with others being made by multinational teams – like the American-German Pfizer vaccine.

Almost all of these nations have prioritised distribution to their own populations.

Speaking at a WHO executive board session on Monday, Tedros said: “I need to be blunt: the world is on the brink of a catastrophic moral failure – and the price of this failure will be paid with lives and livelihoods in the world’s poorest countries.”

Tedros said a “me-first” approach would be self-defeating because it would push up prices and encourage hoarding.

“Ultimately, these actions will only prolong the pandemic, the restrictions needed to contain it, and human and economic suffering,” he added.

The WHO head called for a full commitment to the global vaccine-sharing scheme Covax, which is due to start rolling out next month.

“My challenge to all member states is to ensure that by the time World Health Day arrives on April 7, Covid-19 vaccines are being administered in every country, as a symbol of hope for overcoming both the pandemic and the inequalities that lie at the root of so many global health challenges,” Tedros said.

So far, more than 180 countries have signed up to the Covax initiative, which is supported by the WHO and a group of international vaccine advocacy groups. Its aim is to unite countries into one bloc so they have more power to negotiate with drug companies.

Ninety-two countries – all of them low or middle-income – will have their vaccines paid for by a fund sponsored by donors.

“We have secured two billion doses from five producers, with options of more than one billion more doses, and we aim to start deliveries in February,” Tedros said.

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