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EDITORIAL | New Japanese COVID Drug Xocova Is Just In Time to Help Against 'Eighth Wave'

Relying on Xocova alone is not enough. It should be used with other available drugs according to their characteristics to suppress a resurgence of COVID-19.



Shionogi Pharmaceutical Co, Ltd.'s new coronavirus infection oral medicine "Xocova" (provided by the company).

On November 22, the government gave emergency approval to Xocova, the first domestic Japanese oral drug for use against COVID-19. Developed by the pharmaceutical firm Shionogi & Co it is also the first oral COVID treatment to be authorized for use primarily by patients suffering from mild to moderate symptoms. It is not targeting patients with underlying conditions.  

Increasing the range of treatment for patients with mild illness will be a milestone for managing the eighth wave. COVID infections of that wave are now swinging into full force. We hope Xocova will be used effectively in support of economic and social activities.

Shionogi's domestic production line for Xocova, its new oral drug for the treatment of COVID-19. (© Sankei by Takanobu Sawano)

Ensuring a Smooth Rollout and Stable Supply

To that end, the Ministry of Health, Labor and Welfare should ensure that there are adequate supplies of Xocova available. The ministry should also facilitate a smooth supply for use by the public.

At the same time, we must be careful to avoid having patients with a fever, including those with only light symptoms from swamping outpatient clinics in order to receive Xocova. If that should happen, medical treatment facilities could once again find themselves in turmoil because of the eighth wave.

Identifying Low and High Risk Patients

For some time, the government has been planning how to respond to a sharp increase in the number of patients with high fevers in case COVID-19 starts spreading again. 

Patients at low risk of becoming seriously ill have been asked to self-test and treat themselves at home. However, for a patient with COVID, it is difficult to know when symptoms have become serious enough to go to a clinic to be prescribed Xocova rather than continuing home treatment. 

In response, the government should promote broader use of online medical consultations. Simultaneously, it should be more conscientious in disseminating information to patients. 

Relying on Xocova alone is insufficient to suppress a resurgence in the number of COVID cases. Naturally, other existing drugs should also be employed in accordance with their individual characteristics.

Shionogi Pharmaceutical Research Center, where Xocova was created. Toyonaka City, Osaka (© Sankei by Yuta Yasumoto)

More Options for Patient Treatment

Xocova is targeted at patients with mild to moderate symptoms such as high fever, severe cough or sore throat. 

Nonetheless, the Japanese Association for Infectious Diseases continues to recommend treatment with Pfizer's Paxlovid for high-risk individuals such as the elderly and patients with underlying conditions. Other existing medications should also be considered.

Paxlovid has proven highly effective in treating Omicron and other COVID variants. However, its use in Japan has stagnated due to the fact that it cannot be used in combination with many other drugs. Experts have suggested that patient survival rates could be improved by increasing the use of Paxlovid under medical supervision.


Many drugs cannot be used in combination with Xocova, too. As with Paxlovid, doctors should not blindly avoid prescribing Xocova because of this potential problem. The medical community and the Ministry of Health must encourage medical institutions to make full use of the range of options and choose the remedy that provides the best possible care for a given individual. 

Supporting Domestic Drug Development

At the same time, it has been close to three years since the pandemic first began. It is troubling that only now has a domestically produced oral drug received approval. 

The ability to develop and manufacture pharmaceuticals domestically is critical to ensuring a stable supply of drugs during an emergency. Japanese officials must do everything they can to promote pharmaceutical research and development.


(Read the editorial in Japanese at this link.)

Author: Editorial Board, The Sankei Shimbun

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