The leadership of the Association of Hospital and Administrative Pharmacists of Nigeria, AHAPN; and Clinical Pharmacists Association of Nigeria, CPAN, have advised on the use of Remdesivir and other antiviral drugs for the management of COVID-19, if the need arises to test other drugs for the treatment of the infection in the country.
Although the Director General, National Agency for Food and Drug Administration and Control, NAFDAC, Prof. Moji Adeyeye has said the nation will continue hydroxychloroquine clinical trials, despite the suspension of the trials by the World Health Organisation on Monday.
Dr Kingsley Amibor, AHAPN national chairman, in an exclusive interview with Pharmanewsonline noted that the next logical thing to do, if it becomes compulsory to also put the clinical trials on hold in the country, is to look for other options, in order to shield patients from the effects.
He said: “The Federal Minister of Health did mention sometime ago that Nigeria was making use of Remdesivir to treat COVID-19 patients. So may be this might be the best time for us as a nation to begin to explore fully, the potentials of Remdesivir as an antiviral drug for the treatment of COVID-19 and to include it in our treatment protocol for our country.
“I want to believe clinical trials have been carried out already, but where it has not, then it is important that clinical trials be carried out on it to establish its clinical efficacy and safety status”, he stated.
Amibor further recommended the use of other antiviral combinations which have been tried in several places with encouraging results.
He cited the examples of some combinations deployed in some centres in the country, for the management of the condition.
“Some centres in Nigeria are said to be using combination of amoxycillinplus clavulanic acid, artemether lumefantrine, and ritonavir/lopinavir and so on. Such combinations can be used, if it we have to put hydroxychloroquine on hold in the country, pending when a final cure is found”, he advised.
The AHAPN chairman also urged the management of the National Agency for Food and Drug, Administration and Control, NAFDAC, to fast track the efficacy and safety trials of the Madagascar’s COVID- Organics, so that once it passes the clinical trial tests, then it can be introduced into the treatment protocol in Nigeria.
In addition, he said there are several products submitted to NAFDAC for efficacy and safety trials, hoping that a cure would emerge from herbal products in the nearest future.
For the National Chairman of CPAN, Dr Joseph Madu,: “There is no major problem with the suspension of the clinical trials by WHO, as the agency has said every sovereign nation with effective regulatory body can advise its citizens through its clinicians such as clinical pharmacists, nurse practitioners and physicians on the use of any drug like chloroquine for instance which is already a licensed product”.
He said what this means is that the treatment with chloroquine in COVID-19 patients has not been categorically suspended because the country’s clinicians can weigh the benefits against the risks for patients.
Furthermore, he noted that the WHO said the suspension of the clinical trials is only temporarily paused due to some research concerns and a publication in a scientific Journal the LANCET which cited issues of safety with Chloroquine with or without azithromycin usage.
“The WHO said her monitoring board committee on safety will review the chloroquine data.
“The body made it clear that they had temporarily paused the solidarity chloroquine/hydroxychloroquine clinical trials, but other arms of the trial will continue”
Madu further stated that aside the use of chloroquine, there is a cocktail of other drugs used in the management of COVID-19.
He said, it is the duty of clinical pharmacists at the centre to come up with substitutes or alternative regimen designs as obtainable in advanced climes.
“Therefore, the treatment of COVID-19 patients is not really going to be affected by the WHO temporary suspension of solidarity clinical trials.
Reacting to the new strategy of the Lagos State Government to admit only severe cases at the isolation centres, Amibor said it is not a welcome development, especially at this time when the number of confirmed cases and deaths from Lagos keeps rising. One can understand that the capacity of the isolation centres may be overwhelmed already, but I believe what the government can do is to try to open more isolation centres where newly confirmed cases can be treated.
He added that the government can appeal to public spirited individuals to donate more places to serve as isolation centres. Individuals having hotels can volunteer such. “But to abandon these patients or to leave them in their houses, where they stand the risk of infecting their households or other members of the public will be counterproductive. Managing or treating COVID-19 patients at home only to bring them to the isolation centres when they enter the severe phase of the infection will definitely worsen the spread of COVID-19”, he maintained.
He therefore appealed to the state government to have a rethink on the decision because if anything happens, it will likely increase the spread of the COVID-19 virus.
Dr Madu also uphold the same views as his colleague saying the strategy will not help curb the spread but could rather increase the spread.
While arguing that the measure or decision will likely reduce deaths as the severe cases will be given more serious attention, he urged the federal government and private sector to assist the state in getting more centres.
“The FG can support the state by acquiring more isolation centres with more bed spaces. The private sector such as accredited community pharmacies and private clinics can also be used in testing, monitoring of patients and management of asymptomatic cases, and referrals where necessary”, he added.