KUALA LUMPUR – As South Asia struggles to battle the second wave of Covid-19 infections, a drug initially designed to treat cancer is offering a new ray of hope for Indian doctors in the treatment and management of their patients.
The drug found to help speed up recovery and reduce oxygen dependence was launched by the Indian government and released earlier this week by Defence Minister Rajnath Singh and Health Minister Harsh Vardhan.
The drug, called 2-deoxy-D-glucose (2-DG), was jointly developed by the Institute of Nuclear Medicine and Allied Sciences (Inmas), a lab of the Defence Research and Development Organisation (DRDO), in collaboration with India’s pharmaceutical group, Dr Reddy’s Laboratories in Hyderabad.
The Drugs Controller General of India (DCGI) had on May 1 granted permission for emergency use of the drug as an adjunct therapy (supplementary use) in moderate to severe Covid-19 patients.
2-DG a ‘life-saver’
Speaking to The Vibes, Monash University Malaysia coronavirus expert Prof Sunil K. Lal described the move by the Indian government to offer the 2-DG drug for emergency use as “brilliant”.
“During the current desperate situation in the subcontinent where hospitals are running out of oxygen supply, 2-DG, a repurposed (repositioned) drug that was originally developed for cancer treatment is timely and promising.”
Sunil said 2-DG is a “pseudo D-Glucose” prepared by replacing the -OH group at C2 by a H-atom. Hence, the name 2-Deoxy-D-Glucose, meaning removal of oxygen from second carbon mimics the structure of D-Glucose.
“D-Glucose gets easy passage into cells and breaks down into two three-carbon compounds, one of them being pyruvate anion (CH3COCOO-) with release of energy.
“This metabolic process is called glycolysis. It is this energy on which all living organisms survive, including humans. Coronavirus also survives on this energy inside the infected cell. Unlike D-Glucose, 2-DG is unfit for glycolysis and no energy is evolved. The sustaining of life becomes difficult and, as such, coronavirus life-cycle progression halts due to want of energy.”
He also said the cell requires oxygen for glycolysis – by administering 2-DG to patients and stalling glycolysis, the body’s cells demand oxygen drops significantly and this allows the body to prioritise its available oxygen to the brain cells where it is required to maintain proper functioning.
“With Covid-19 patients having lower absorption of oxygen, 2-DG acts as a ‘life-saver’ and provides the much-needed time and support for the lungs to recover their efficient functioning.”
According to an Indian government release, 2-DG accumulates in the virus-infected cells and prevents virus growth by stopping virus replication. What makes this drug unique is its selective accumulation in the infected cells, it said, adding, the drug should also work against the different variants of the Covid-19 virus.
2-DG drug trials
In April last year, Inmas-DRDO scientists conducted experiments and found that 2-DG works effectively against Covid-19 and inhibits viral growth. Based on the results, Phase Two trials were permitted and carried out between May and October 2020.
The drug was found to be safe for humans and Covid-19 patients who were administered the drug showed faster symptomatic cure than patients in the standard care group.
Following this outcome, Phase Three trials were carried out on 220 patients between December 2020 and March this year at 27 Covid hospitals across several states.
The results showed that a significantly higher proportion of patients in the 2-DG group improved symptomatically and became free from supplemental oxygen dependence in comparison with those in the standard care group, said the government release.
“A similar trend was observed in patients aged more than 65 years,” it added.
According to the release, the oral drug, which will be made available in mid-June, not only saves lives, but can reduce the length of hospital stays of patients.
Today, 10,000 doses of 2-DG are to be released by DRDO and large-scale production is being ramped up to start production in Dr Reddy’s facility in Hyderabad. – The Vibes, May 23, 2021
