Mumbai, May 17, 2021: Adding another ammo to our battle against COVID19, the Government of India has introduced a promising anti-COVID19 drug called 2-deoxy-D-glucose (2-DG). The drug has been developed by the Institute of Nuclear Medicine and Allied Sciences (INMAS), a lab of Defence Research and Development Organisation (DRDO), in collaboration with Dr Reddy’s Laboratories (DRL), Hyderabad. The drug was approved for emergency use as an adjunct therapy in moderate to severe COVID19 patients by the Drugs Controller General of India (DCGI) early this month.
WHAT IS 2-DEOXY-D-GLUCOSE (2-DG)? 2-Deoxy-D-Glucose drug has historically been extensively tested for treating Cancer but is so far an unapproved drug. However, for COVID19, the drug shows promise. The drug comes in powder form in a sachet, which is taken orally by dissolving it in water. It accumulates in the virus-infected cells and prevents virus growth by stopping viral synthesis and energy production. Its selective accumulation in virally infected cells makes this drug unique. The Institute of Nuclear Medicine and Allied Sciences (INMAS), a lab of the DRDO, in collaboration with Dr Reddy’s Laboratories (DRL), Hyderabad, has been studying this drug in the context of radiation therapy for cancer.
The primary mechanism of the drug involves inhibiting glycolysis or one of how cells break down glucose for energy. While used to starve and kill cancer cells, this approach could also work in inhibiting virus cells too that were dependent on glycolysis for replication. When the pandemic broke out in India, INMAS, DRDO, and DRL switched their effort to explore the possibilities to use this drug to defeat COVID19. Tests at the Centre for Cellular and Molecular Biology, Hyderabad, last year indicated that the drug demonstrably killed virus cells after which it progressed to trials in people.
2-DEOXY-D-GLUCOSE DRUG CLINICAL TRIAL: GATHERING CLINICAL EVIDENCE AND EFFICACY. In April 2020, INMAS started experimental examinations in Hyderabad with the Centre for Cellular and Molecular Biology (CCMB). After which, the Central Drug Standard Control Organisation (CDSCO) and the Drug Controller General of India (DCGI) jointly granted permission for Phase-2 trials in May 2020. Between May to October 2020, the institute started initial trials on how COVID19 patients would respond to the drug. The drug worked well with no side effects, and the patients recovered quickly. Further on, the Phase 3 clinical trial was conducted between November 2020-March 2021 in Delhi, UP, Bengal, Gujarat, Maharashtra, Telangana, Andhra, Tamil Nadu, and Karnataka. The results were favourable.
THE EFFICACY FACTOR: Clinical trial results have shown that this molecule helps in faster recovery of hospitalised patients and reduces supplemental oxygen dependence. The drug will be of immense benefit to the people suffering from COVID19. As per clinical data for efffficacy trends, the patients treated with the 2-DG drug showed faster symptomatic cure than Standard of Care (SoC) on various endpoints. A significantly higher proportion of patients improved symptomatically and became free from supplemental oxygen dependence (42% vs 31%) by day-3 compared to SoC, indicating an early relief from Oxygen therapy/dependence.
ACTING WITH RESPONSIBILITY: This drug comes when our nation is grappling to cope with the impact of the devastating second wave of COVID19, which has stressed our infrastructure and resources to its limit. I see a ray of hope, that with the availability of this drug, we may be able to reduce the burden of COVID19 and save as many lives as possible. Having said that, precaution is a must. No COVID19 medication should be taken without a doctor’s prescription. Moreover, hoarding drugs is a crime, and as responsible citizens of the nation, we must ensure that these medicines should be available and accessible to those who need it.
(Dr Rahul Pandit is Director-Critical Care, Fortis Hospitals Mumbai & Member of Maharashtra’s COVID Taskforce)