Explained: What is DRDO's anti-COVID drug 2-deoxy-D-glucose (2-DG) and how it works?
The Drug Controller General of India (DCGI) has approved the emergency use of 2-DG as additive therapy for moderate to severe COVID-19 patients. Being a generic molecule and analogue of glucose, it can be easily produced and made available in India. The anti-COVID-19 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 clinical trials have shown that 2-deoxy-D-glucose (2-DG) helps in faster recovery of hospitalised patients and reduces dependency on supplemental oxygen. Patients treated with the aforementioned drug showed RT-PCR negative conversion in COVID patients. As per the experts on the subject, the drug will be beneficial in treating patients suffering from COVID-19.
Clinical trials and their results
In April 2020, the scientists at INMAS-DRDO and CCMB, Hyderabad jointly conducted laboratory experiments and concluded that the molecule works effectively against the SARS-CoV-2 virus and inhibits viral growth. On the basis of these results, DRDO's CDSCO permitted phase-II clinical trials on COVID-19 infected patients in May 2020.
DRDO and its industry partner DRL, Hyderabad jointly started clinical trials to test the safety and efficacy of the drug in COVID-19 patients. The drug was found to be safe and showed significant improvements in the recovery of COVID-19 patients. Phase-IIa was conducted in six hospitals while Phase-IIb was (dose-ranging trial) conducted at 11 hospitals pan India.
The phase-II trial was conducted on 110 COVID-19 patients between May to October 2020. In terms of efficacy, the patients treated with 2-DG showed faster symptomatic recovery than Standard of Care (SoC) on various endpoints.
The Phase-III clinical trials were carried after the approval from DCGI. It was conducted on 220 patients from December 2020 to March 2021 at 27 COVID-19 hospitals located in Delhi, Uttar Pradesh, West Bengal, Gujarat, Rajasthan, Maharashtra, Andhra Pradesh, Telangana, Karnataka and Tamil Nadu.
The data reveals that a significant number of patients improved symptomatically and became free from supplemental oxygen dependence (42% vs 31%) by Day-3 in comparison to SoC, indicating an early relief from Oxygen therapy or dependence. A similar trend was observed in patients above the age of 65 years.
How 2-deoxy-D-glucose (2-DG) works?
The 2-deoxy-D-glucose (2-DG) comes in sachet in powder form and has to be taken orally by dissolving it in water. The drug accumulates in the virus-infected cells and prevents its growth by stopping viral synthesis and energy production. The USP of the drug is its selective accumulation in virally infected cells.
In the ongoing second wave of the COVID-19 pandemic, patients are facing severe oxygen dependency and need hospitalisation. In such a scenario, the anti-COVID drug is expected to save lives due to the mechanism of operation of the drug in infected cells, thereby reducing hospital stay of the COVID-19 infected patients.
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