NEW DELHI: Amid the reports of a mad rush for experimental drugs such as Remdesivir and Tocilizumab for Covid-19, the Centre has asked states and medical colleges across the country to focus mainly on standard care and cautioned against indiscriminate use of investigational therapies.
Experts from the Indian Council of Medical Research (ICMR) and AIIMS-Delhi on Friday underlined that for moderate and severe cases, adequate oxygen support, appropriate and timely administration of anti-coagulants and widely available and inexpensive corticosteroids should be considered the mainstay of Covid-19 therapy.
While some repurposed drugs indicated as investigational therapies, states were reminded, have been approved by the Drug Controller General of India (DCGI) only for emergency use in case of Covid-19 and should be used with “caution” only in hospital settings.
“These can be used in specific sub-groups of patients on the basis of informed and shared decision making with the patient before prescribing these drugs... their indiscriminate use or use in conditions for which they are not desirable, may cause more harm than good,” the Union Ministry of Health and Family Welfare said in a statement.
The states have been told that the available evidence for Remdesivir suggests that it may decrease the time for clinical improvement when used in moderate to severe cases but there have been no benefits in terms of reduced mortality.
“It has to be used with extreme caution due to its potential for serious adverse effects including liver and kidney injury,” said the Centre.
“Similarly, Tocilizumab studies have not shown any benefits in mortality reduction. Rampant use is to be discouraged since the effect of the drug is directed at the “cytokine storm”.
The government reiterated that the approach for the treatment of Covid-19 is largely based on asymptomatic and supportive care since there is no cure as yet.
For mild cases, which are about 80 per cent of all cases, the government again asked states to routinely recommend anti-malarial drug hydroxychloroquine — even though studies in most countries have now nearly established that the medicine does not improve clinical outcomes related to the disease.
For moderate to severe cases, the government said, the focus of clinical management should continue to remain on oxygen therapy (including high flow nasal oxygen), steroids, appropriate and timely administration of anticoagulants and high-quality supportive care, including mental health counselling for patients and families, pruning, management of pre-existing illness and palliation of symptoms.