New treatments for COVID-19
Monoclonal antibody treatments have revolutionised cancer care. Herceptin, which is used to treat breast cancer, is just one good example. Now the same treatments may be able to achieve results with COVID-19 too.
Monoclonal antibody therapy
Monoclonal antibodies are antibodies (blood proteins that fight infections or disease inside the body) which are engineered to fight a specific target. Eli Lilly, an international pharmaceutical business, has made two types to tackle COVID-19.
Results from a Phase 2 trial being run at the Cedars-Sinai Medical Centre in California are showing some incredibly promising effects. The results from the “BLAZE-1” trial have just been published in the New England Journal of Medicine. The trial is a randomised, double-blind, placebo-controlled study. It has 800 participants and is a robust clinical trial.
Engineered to fight the virus
The first treatment, Bamlanivimab, is designed to block the virus from entering human cells, thus neutralizing the infection. It is targeted at the ‘spike protein’ of COVID-19. It originates from a blood sample taken from one of the first U.S. patients who recovered from COVID-19.
The second, Etesevimab, also targets the COVID-19 ‘spike protein’. It covers the spike and blocks the virus from binding to a cell in the body (the ACE2 host cell surface receptor). It acts in a similar way to covering a key with Sellotape.
In Phase 1 safety trials, these two treatments were shown to be effective as both prophylactic and therapeutic treatments. They showed they could be useful to prevent infection, as well as for treating infected patients. Donald Trump was treated with monoclonal antibodies, amongst other interventions.
The results of the Phase 2 trial just published show that the antibodies reduced viral load, symptoms and COVID-related hospitalisations. The combination of both therapies significantly reduced viral load at day 11, which was the aim of the trial. Most patients demonstrated near complete viral clearance by day 11.
An improvement in symptoms was observed in patients as early as three days after treatment with one or both monoclonal antibody therapies. The rate of COVID-related hospitalisation was significantly lower for patients treated with the therapy (0.9%) versus the placebo (5.8%). That delivers a relative risk reduction of 85.5%. It is a very positive step for any patients who may become severely unwell.
Eli Lilly commented “We believe the data generated to date provides sufficient evidence that both monotherapy and combination therapy may be effective to treat COVID-19 in patients with a high risk for serious outcomes.”
More to come
The firm also has other well developed trials that are already in Phase 3 (large scale) testing. One is specifically aimed at preventing COVID-19 amongst residents and staff in long-term care facilities. Other monoclonal antibodies are also being tested in the ACTIV-2 and ACTIV-3 trials being run by the National Institutes of Health in the US.
The results are testament to the ingenuity and skill of an international team of scientists. That the treatments have been developed in such a short time is remarkable. The prospect of more effective treatments for COVID-19 is moving closer every day.
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