Adding another leg to our battle against COVID19, the Government  of India has introduced, a promising anti-COVID19 drug called 2-deoxy-D-glucose  (2-DG). The 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 drug was approved for emergency use as an adjunct therapy in moderate to  severe COVID19 patients by the Drugs Controller General of India (DCGI) early  this month.
    WHAT IS 2-DEOXY-D-GLUCOSE (2-DG)? 
The 2-Deoxy-D-Glucose drug has  historically been extensively tested for treating Cancer but is so far an  unapproved drug. However, for COVID19, the drug shows promise. The drug comes  in powder form in a sachet, which is taken orally by dissolving it in water. It  accumulates in the virus-infected cells and prevents virus growth by stopping  viral synthesis and energy production. Its selective accumulation in virally  infected cells makes this drug unique. The Institute of Nuclear Medicine and  Allied Sciences (INMAS), a lab of the DRDO, in collaboration with Dr Reddy's  Laboratories (DRL), Hyderabad, has been studying this drug, in the context of  radiation therapy for cancer.
    The basic mechanism of the drug involves inhibiting glycolysis or  one of the ways in which cells break down glucose for energy. This approach  while used to starve and kill Cancer cells could also work in inhibiting virus  cells too, that were dependent on glycolysis for replication. When the pandemic  broke out in India, INMAS, DRDO and DRL switched their effort to explore the  possibilities to use this drug to defeat COVID19. Tests at the Centre for  Cellular and Molecular Biology, Hyderabad, last year indicated that the drug  demonstrably killed virus cells after which it progressed to trials in  people.
    2-DEOXY-D-GLUCOSE DRUG CLINICAL TRIAL:  GATHERING CLINICAL EVIDENCE AND EFFICACY.
 In April 2020, INMAS started experimental examinations in  Hyderabad with the Centre for Cellular and Molecular Biology (CCMB). After  which, the Central Drug Standard Control Organisation (CDSCO) and the Drug  Controller General of India (DCGI) jointly granted permission for Phase-2  trials in May 2020. Between May to October 2020, the institute started initial  trials on how COVID19 patients would respond to the drug. The drug worked well  with no side effects and the patients recovered quickly. Further on, the Phase  3 clinical trial was conducted between November 2020 - March 2021 in Delhi, UP,  Bengal, Gujarat, Maharashtra, Telangana, Andhra, Tamil Nadu, and Karnataka. The  results were favourable.
    THE EFFICACY FACTOR:
 Clinical trial results have shown that  this molecule helps in faster recovery of hospitalised patients and reduces  supplemental oxygen dependence. The drug will be of immense benefit to the  people suffering from COVID19. As per clinical data for efficacy trends, the  patients treated with the 2-DG drug showed faster symptomatic cure than  Standard of Care (SoC) on various endpoints. A significantly higher proportion  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/ dependence.
    ACTING WITH RESPONSIBILITY:
 Approval and availability of this drug  have come at a time when our nation is grappling to cope with the impact of the  devastating second wave of COVID19, which has stressed our infrastructure &  resources to its limit. I see a ray of hope, that with the availability of this  drug we may be able to reduce the burden of COVID19 and save as many lives as  possible. Having said that, precaution is a must. No COVID19 medication should  be taken without a doctor's prescription. Moreover, hoarding drugs is a  crime and as responsible citizens of the nation, we must ensure that these  medicines should be available and accessible to those who need them.
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