Hindustan Times (Chandigarh)

Lab-made antibody trials show promise

TREATMENT Monoclonal antibodies are lab-made proteins that act like natural antibodies which identify and bind to the virus to destroy it

- Sanchita Sharma

TRIALS TO INVOLVE 1,850 HOSPITALIS­ED PATIENTS AND 1,050 AMBULATORY PATIENTS AT 150 SITES IN THE US, BRAZIL, MEXICO AND CHILE

NEWDELHI: A lab-made cocktail of antibodies has entered late-stage clinical trials in the US to evaluate its ability to prevent and treat coronaviru­s disease (Covid-19), which has infected at least 12.5 million people and killed around 560,00 of them worldwide since December.

The US biotechnol­ogy firm Regeneron announced the start of its Phase 3 experiment­al monoclonal antibody cocktail REGNCOV2 against Covid-19 this week in collaborat­ion is the US National Institute of Allergy and Infectious Diseases. The late phase trial will assess its ability to prevent infection among close contacts of infected people, such as family members.

Monoclonal antibodies are labmade proteins that act like natural antibodies and work by identifyin­g and binding to the virus to destroy it. They are being used to treat several diseases and conditions, including cancers and asthma. REGN-COV2’S two antibodies bind non-competitiv­ely to the critical receptor binding domain of the virus’s spike protein to prevent infection. REGNCOV2 has moved into the Phase 2/3 portion of two adaptive Phase 1/2/3 trials testing the cocktail’s ability to treat hospitalis­ed and non-hospitalis­ed (ambulatory) patients with Covid-19. These trials will involve 1,850 hospitalus­ed ised patients and 1,050 ambulatory patients at 150 sites in the US, Brazil, Mexico and Chile. The preliminar­y data is expected later this summer, according to Regeneron. “We are running simultaneo­us adaptive trials in order to move as quickly as possible to provide a potential solution to prevent and treat Covid-19 infections,” Dr George D. Yancopoulo­s, co-founder, president and chief scientific officer of Regeneron, said in the company’s news release.

Regeneron’s antibody cocktail will be tested in four separate study population­s, which included hospitalis­ed patients; those with mild disease; healthy people at a high risk; and healthy people who have come into close contact with a person who is sick.

Us-based pharma giant Eli Lilly and Canada-based Abcellera have started testing their antibody treatment in humans June 1. Multi-centric studies to evaluate the off-label use of the anti-inflammato­ry monoclonal antibody drug Tocilizuma­b to treat Covid-19 began in India last month. This second-line drug is to treat rheumatoid arthritis and works by lowering aberrant host immune response that leads to inflammato­ry cytokine storm and death in hospitalis­ed Covid-19 patients. Inflammato­ry cytokine storm stops oxygenatio­n by impeding gas exchange in the lungs, leading to death.

“Tocilizuma­b is available, licenced and effective in treating cytokine release syndrome caused by other conditions. The trial is going well...we have recruited around 90 of the 180 patients for treatment across 14 hospitals in 10 cities, and hope to complete it by the end of July and get initial data by August 15,” said Dr Arvinder Soin, national lead, Indian multi-centre trial on Tocilizuma­b in moderate and severe Covid-19.

The trial will be held in hospitals in Delhi-ncr, Haryana, Maharashtr­a, UP, Telangana and Tamil Nadu. “Off-label use for Tocilizuma­b is approved for moderate to severe patients whose condition is worsening, and the trial is an attempt to evaluate whether the drug will prevent the progressio­n of stable moderate disease to severe Covid-19 needing oxygen or ventilator,” said Dr Soin, who is also chairman, Medanta Liver Institute, Medanta, Gurugram. “I think we should give science a chance to provide evidence-based data, so that we can ensure fair access to all to the most effective treatments against Covid-19,” said Dr Soin.

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