November 29, 2022

The companies Merck (Merck Sharp and Dohme) and Ridgeback Biotherapeutics LP stated their oral antiviral drug Molnupiravir is less effective in reducing the risk of hospitalization and death among at-risk adult patients with mild to moderate Covid-19 than was previously reported. In the larger study MOVe-OUT which involved 1,433 patients, it was shown that efficacy was 30 percent, not 50 percent. In the United States, the two companies have applied for emergency use authorization.
The U.S. Food and Drug Administration has raised concerns on the possibility that the drug may cause viral mutations or cause birth defects in humans. Molnupiravir is designed to introduce errors in the genetic code of the virus and prevent it from replicating.
Pfizer’s own experimental oral drug Paxlovid showed an efficacy of 89 percent reduction in hospitalizations and death among high-risk adults. Paxlovid is designed to block an enzyme that the SARS-CoV2 virus needs to replicate.
Vaccination-averse persons may tend to rely on these new drugs in a treatment-inclined mindset. There are new (and experimental) drugs that seem to be “game changers” but prevention is still the best approach.

The new variant Omicron initially reported in South Africa is said to have a “very unusual constellation of mutations.” It was noted that the new variant has 10 mutations in the protein that is used by the virus to enter and infect cells, compared to the Beta variant with three mutations, and the Delta variant with two. Little is known about Omicron. It can cause milder or less symptomatic disease or an illness with shorter duration but it has been shown to be more rapidly transmitted. There is no proof yet that it can reduce protection from the currently used vaccines. Omicron has already overtaken Delta as the most prevalent variant in South Africa.

What is the best treatment for osteoarthritis?
Pain and limitation in mobility or movements are the main health problems caused by osteoarthritis.
Treatment of pain can be achieved temporarily with the use of pain relievers that include anti-inflammatory drugs.
Drugs that control inflammation include steroids (Prednisone, Methylprednisolone) and nonsteroidal anti-inflammatory drugs (NSAIDS).
Examples of NSAIDs are Rofecoxib, Diclofenac, mefenamic acid, Ibuprofen. Steroids are not the first drug of choice in treating osteoarthritis and are not recommended for prolonged use. Side effects include irritation of the stomach lining (some patients develop ulcers and bleeding, elevation of blood sugar (steroid-induced diabetes mellitus) and osteoporosis leading to fractures.
NSAIDS are not also for prolonged use. Side effects include stomach irritation and kidney damage. A person with osteoarthritis has to accept that the disease is chronic and with recurrent symptoms.
Bone changes are not reversible hence a person needs to make necessary adjustments in his or activities to lessen the pain and the need for analgesics. Treatment may involve several consults with one’s attending physician and referrals to specialists. Treatment cannot be achieved with a one-time consultation and simple prescription of pain relievers.

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