Omicron could sideline 2 older COVID-19 drugs
WASHINGTON – As strained U.S. hospitals brace for a new surge of COVID-19 cases caused by the fast-spreading omicron variant, doctors are warning of yet another challenge: the two standard drugs they’ve used to fight infections are unlikely to work against the new strain.
For more than a year antibody drugs from Regeneron and Eli Lilly have been the go-to treatments for early COVID-19, thanks to their ability to head off severe disease and keep patients out of the hospital.
But both drugmakers recently warned that laboratory testing suggests their therapies will be much less potent against omicron, which contains dozens of mutations that make it harder for antibodies to attack the virus. And while the companies say they can quickly develop new omicron-targeting antibodies, those aren’t expected to launch for at least several months.
A third antibody from British drugmaker Glaxosmithkline appears to be the best positioned to fight omicron. But Glaxo’s drug is not widely available in the U.S., accounting for a small portion of the millions of doses purchased by the federal government and distributed to states.
“I think there’s going to be a shortage,” said Dr. Jonathan Li, director of the Harvard/brigham Virology Specialty Laboratory. “We’re down to one Fdaauthorized monoclonal antibody” with omicron as the Regeneron and Lilly drugs lose effectiveness.
The delta variant still accounts for more than 95% of estimated U.S. cases, according to the Centers for Disease Control and Prevention. But agency leaders say omicron is spreading faster than any past variant and will become the dominant strain within weeks.
Delivered by injection or infusion, antibodies are laboratory-made versions of human proteins that help the immune system fight off viruses and other infections.
Dr. James Cutrell said officials likely will allocate Glaxo’s antibody based on federal surveillance data showing which variant is circulating where.
“Once certain regions cross a percentage of omicron they’re likely to start distributing the product to those regions,” said Cutrell of the University of Texas Southwestern Medical Center. “That’s really going to be the treatment of choice.”
London-based Glaxo says it is on track to produce 2 million doses by May, under contracts with the U.S., Canada, the U.K., Japan and several other countries. The company is working to add manufacturing capacity.
The drugs from Pfizer and Merck would be the first treatments Americans can take at home to head off severe disease. Pfizer’s drug in particular has shown a powerful effect, curbing hospitalizations and deaths by nearly 90% in high-risk patients.
“If it’s rolled out effectively this has a real big potential,” to make up for antibody treatments, said Andrew Pekosz, a virologist at Johns Hopkins University. “That’s an immediate place where these antivirals could minimize the impact of omicron.”