India’s first indigenous anti-Covid-19 drug is a repurposed trial medicine for cancer

Amid fears of the new Delta variant and the anticipated third wave, an Indian pharma major has come out with an oral Covid-19 drug.

On June 28, Dr Reddy’s Laboratories commercially launched its 2-deoxy-D-glucose or 2-DG in India at a maximum price of Rs 990 per sachet. “In the initial weeks, the company will make the drug available in hospitals across metros and tier-one cities, and subsequently expand the coverage to the rest of India,” the pharma company said in its media statement.

2-DG for Covid-19

2-DG, which is being touted as India’s first indigenous anti-Covid-19 drug, is a repurposed medicine that was being used in trials for cancer treatment.

The drug has been developed by the Institute of Nuclear Medicine & Allied Sciences, a laboratory of the Defence Research and Development Organisation, in collaboration with Dr Reddy’s.

The Hyderabad-based pharma firm was given the approval to study 2-DG in 2014 as part of a collaboration with DRDO’s Institute of Nuclear Medicine & Allied Sciences. The company and Institute of Nuclear Medicine & Allied Sciences are still studying 2-DG in the context of being used in radiation therapy for cancer.

On May 1, the drug got emergency use approval for Covid-19 treatment.

For Covid-19, the drug can currently be administered only on prescription. “The drug should be given under the supervision of a qualified physician to hospitalised moderate to severe Covid-19 patients as an adjunct therapy to the existing standard of care,” the company said. An adjunct therapy is given along with the primary treatment, without making any changes to the existing course.

Concerns over drug

Medical experts have expressed scepticism about the efficacy of 2-DG in the past, particularly questioning the evidence on which the drug was approved.

The concerns mostly stem from the lack of published data on how the drug performed during human trials. The company has not yet published the results of the phase-2 and 3 trials, and the only information available about its efficacy is through government press releases and the trials’ registrations on the Clinical Trial Registry of India.

“I would only use it in research mode till we have data in the public domain,” Dr Shashank Joshi, an expert member in the Maharashtra Covid task force, told Deccan Herald newspaper in May. “Studies have not been done in the population of diabetics and those with coronary artery disease. It may be useful in mild to moderate disease after validation in research mode.”

Another concern around 2-DG is that despite being used in cancer treatment, the drug still remains unapproved and therefore has the potential to harm healthy cells within a human body. 2-DG has been used to inhibit glycolysis – a process through which cells break down glucose in a body. This helps the viruses in the body to get the energy to replicate and spread further.

This article first appeared on Quartz.