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The nickname comes from the former president of the United States, Donald Trump, who after being infected with covid-19 was treated with the preparation that is a “cocktail”, a mixture of two antibodies. Right now, side talks are taking place with the Swiss pharmaceutical giant Roche, which is the manufacturer.
– An EU procurement is underway in which a framework agreement is being drawn up. The National Health and Welfare Council is also already in dialogue with the Swedish side of the company and will eventually invite Roche to reach a local agreement in line with the EU agreement. As soon as it’s ready, we expect a delivery, says Marie State, director of the drug office for the National Board of Health and Welfare.
However, it is not very clear when the drug will arrive in Sweden.
– The companies have not been able to specify when it is possible to receive deliveries, says Maria State.
Four medications
So far, covid care has to settle primarily for four drugs: remdesivir, dexamethasone, tocilizumab, and bamlanivimab. According to the National Board of Health and Welfare, access is good for everyone, but they are used in a limited way. The explanation is that only a few patients actually qualify for the drugs.
For example, remdesivir, which was first developed for Ebola, should only be used very early in the course of the disease in hospitalized patients requiring oxygen therapy.
– It’s a small group where strapsivir works, says Maria State.
Bamlanivimab, an antibody preparation developed specifically for COVID-19, is also used only in a limited group of patients. The drug is also completely new and only began to be used in Swedish hospitals in March.
– I asked a Karolinska doctor if they intended to increase use. Then he said that so far it is too early to say but so far they are satisfied, says Maria State on the National Board of Health and Welfare.
TT: Is medical care too restricted with this drug?
– We do not know. Right now we cannot say that care is too restrictive. It is a completely new drug with a completely new treatment strategy. But they are looking to expand the group that receives the drug.
Dreaming of pills
Despite four EU-approved vaccines, and several on the way, there is a lack of really good covid antiviral drugs, says Lars-Magnus Andersson, president of the Swedish Infectious Diseases Society. You dream of a drug in tablet form that can be taken immediately when exposed to a covid infection.
– Good substances are hard to find and it takes longer than developing a vaccine.
So, the Trump cocktail, how important can a part have for the care of the Swedish covid? Lars-Magnus Andersson doesn’t think much, although of course antibody preparation can help a lot.
– It is likely that there are a limited number of patients who will be treated with this, that is, those who have a weakened immune system, are at risk of serious disease and where the infection is detected early.
Erik Nilsson / TT
it is an antiviral drug substance, like antibiotics fixed against viruses. The drug, which was first developed to combat Ebola, is sold by manufacturer Gilead under the Veklury brand. The drug should prevent the coronavirus from multiplying.
it is a synthetic steroid hormone (cortisone preparation). A large study in the UK has shown that dexamethasone reduces mortality in patients with severe COVID. Dexamethasone has been approved as a medicine in Sweden since the late 1950s.
is a monoclonal antibody against the coronavirus spike protein that prevents the virus from infecting cells. The drug has an emergency license, which means that it is not approved, but it can still be used for a special license.
it is a monoclonal antibody that is also used to treat rheumatism.
, or Regn-Cov2 is a mixture of two monoclonal antibodies: casirivimab and imdevimab.
There is concern that the widespread use of monoclonal antibodies could drive mutations in the coronavirus. Therefore, the National Board of Health and Welfare strives to make several different preparations from the pool of available monoclonal antibodies, as the risk is then reduced.
Source: Medical Products Agency, National Board of Health and Welfare.
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