Introduction of 2DG drug
2DG Stands for 2-deoxy-D-glucose and it is a glucose analogue, that looks like glucose but is not since 2-deoxy-D-glucose changes into 2-deoxy-D-glucose- 6-phosphate by the enzyme, hexokinase and is not further utilized due to acting as inhibitors of other enzymes of the glycolysis pathway. This is the reason, energy is not created. It is also applicable for treating tumours, and cancer cells. This 2DG inhibits SARS-CoV-2 multiplication and thus there will not be a sudden increase in the demand for oxygen in our body.
Mode of Action of 2-deoxy-D-glucose
2DG is a glucose analogue and fast multiplying cells like tumours or cancer cells than our normal body cells need a high amount of glucose for energy. This virus (SARS-CoV-2) is multiplying in the body the same way and therefore it takes this glucose analogue and gets arrested that stops the virus from multiplying.
Impact of 2DG among other COVID-19 treating drugs
Comparative study of 2-deoxy-D-glucose among Hydroxychloroquine, Remdesivir, Ivermectin has shown that 2DG is the first one to be termed as an anti-Covid-19 drug. The apex drug controller of India has allowed this drug for emergency use among Covid-19 patients.
How will it treat Covid-19 patients with oxygen levels decreasing?
When the virus is multiplying fast in the body, oxygen demand increases. Ceasing the virus multiplying process is due to 2DG reduces oxygen crisis.
Will this drug work on mutant or variants of the virus?
Mutant or variants of the virus is still virus and no doubt, it needs glucose as energy for multiplying and hence will get trapped by the drug.
Availability of 2DG
It will be available in marker most probably since June 2021.
Price of 2-deoxy-D-glucose drug
Price has not been fixed so far but the government and manufacturers are keeping affordability in mind.
Dosage of 2-deoxy-D-glucose
2DG is like glucose powder and it can be taken with water, twice a day (a total of 90 mg/kg per day). A Covid-19 patient may have to take this medicine for 5 to 7days to get completely cured.
Merits of 2-deoxy-D-glucose
- The 2-DG being a generic molecule and an analogue of glucose can be easily produced and made available in large quantities.
- The drug is available in powder form in a sachet as shown above image and can be taken orally after dissolving in water.
Demerits of 2-deoxy-D-glucose
- Indian news and opinion websites, The Wire as well as Hindu noted that the approval was based on poor evidence; no journal publication (or preprint) concerning efficacy and safety are yet available.
- There is ignorance of Clinical Trials Registry – India (CTRI) and WHO’s Clinical Progression Scale.
- A smaller study conducted in the US, published in September 2010 reported that 60 mg/kg of 2-DG per day was shown to cause a severe cardiac condition among cancer patients.
- Another study, published in December 2012, found that ingesting 63-88 mg/kg of 2-DG per day could increase blood sugar levels.
Keynotes on 2-deoxy-D-glucose Drug to Treat Covid-19
- This is the first drug that made in India for COVID patients but it was using earlier in tumour or cancer patient.
- Development: The 2DG has been developed by the Defence Research and Development Organisation’s (DRDO) laboratory Institute of Nuclear Medicine and Allied Sciences(INMAS)
- Manufacturer: Dr Reddy’s Laboratories (Hyderabad-based ) has been a partner and it is manufacturing the drug for public use.
- On May 01, 2021, the Drugs Controller General of India (DGCI) has approved the oral drug for emergency use as an adjunct therapy in moderate to severe COVID-19 patients.
- Researchers were involved in this 2DG drug trial for 13 months (April 2020 to April 2021).
- 2DG has passed both in vitro ( laboratory experiment with the help of Centre of Cellular and Molecular biology ) and in vivo ( phase-1, phase-2 and phase-3 clinical trials).
- Inefficacy trends, 2DG shown faster recovery of hospitalized patients and reduces supplemental oxygen.
- On Monday, 17 May 2021 Defence Minister Rajnath Singh and Union Health Minister Dr Harsh Vardhan released the batch of anti-COVID-19 2DG.
Bibliography
- https://www.hindustantimes.com/india-news/drdos-2dg-medicine-to-treat-covid-19-availability-dosage-price-101621160474807.html
- https://timesofindia.indiatimes.com/india/drdos-2-dg-anti-covid-drug-all-you-need-to-know/articleshow/82701791.cms
- https://indianexpress.com/article/explained/drdos-new-oral-drug-2-dg-coronavirus-7318447/
- https://en.wikipedia.org/wiki/2-Deoxy-D-glucose
- https://science.thewire.in/the-sciences/dcgi-drdo-2-dg-covid-19-treatment-phase-2-3-trials-shoddy-evidence/
- https://www.thehindu.com/news/national/govt-releases-drdos-covid-drug-for-emergency-use/article34579529.ece
- https://www.thehindu.com/news/national/questions-remain-on-drdos-covid-drug/article34537596.ece