Dexamethasone & MoAbs COVID Rx

The Economist March 27th 2021 |Technology Quarterly|pp6-7|Treatments|”Finding what works” “With no time to design new drugs, the pandemic was always going to start as a come-as-you are party”

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As soon as February 2020 more than “200 clinical trials were underway” searching in small studies to find existing drugs that would be effective in reducing death, lessening the need for mechanical ventilation or shorten hospital stays associated with Covid-19 infections. The drug classes tested were antivirals, immune modulators, anti-inflammatory, Chinese traditional medicine and others. None of these immediate studies were definitive. Meanwhile drug companies focused efforts on targeted monoclonal antibodies treatments specific for features of Covid and Covid infected cells. Newer methods like CRISPR gene-editing technologies have help speed new developments.

Treatments Approved in G20 Countries

Dexamethasone; a steroid anti-inflammatory drug reduces death and is inexpensive <$6

Remdesivir; an antiviral (Gilead Sciences) reduces recovery time given only by I.V. infusion at a high cost of $2-$K

Tocilzumab; an IL-6 blocking monoclonal antibody (Roche) reduces death and recovery time given only by I.V. infusion at a cost of $700-$1,400.

Bamlanivimab; an Anti-Sars-CoV-2 antibody (Eli Lily) reduces death given only by I.V. infusion at a cost of about $1,000.

Regen-COV; Anti-Sars-CoV-2 antibody (Regeneron) reduces death and hospitalizations only by infusion at a cost of $1,500-$6,500.

So far Dexamethasone has been most impressive when treatment is started at the appropriate time in the disease and is “credited with saving more than 600,000 lives.” The death rate in Britain has decreased as a result from “31% in March-May2020 to about 12%.” Experts worry that Covid-19 may appreciably mutate and evade targeted drugs but George Scangos (Vir Biotechnology) reports their monoclonal antibody, targeted at proteins shared amongst other coronaviruses, “reduce[s] hospitalization or death by 85%.” The strategy is based on the belief that if the target proteins are common amongst corona viruses then they must be essential and immutable. Longer-term there is hope that new research efforts will yield antiviral pills that will be effective against a broad spectrum of viral infections.