19 June 2020 | Views | By Gustav Ando
We are more interested in the development of “antibody cocktails” such as those being developed at Regeneron (US) and Vir (US)
In the absence of a vaccine, effective therapeutics for COVID-19 and its complications are urgently being sought to help mitigate the most serious consequences of infection and to reduce the duration of virus shedding and infectivity.
This is especially important since the timeline for approval of a repurposed known medicine would be much shorter than that for a vaccine, since safety would already be established.
There has been a major research effort worldwide, with hundreds of trials and investigations having been initiated for a wide range of existing and novel compounds, with varied degrees of success.
We expect the most dramatic developments in the research and development (R&D) landscape here not to come from remdesivir, hydroxychloroquine, or other repurposed treatments, although we do see a critical role for existing treatments being repositioned to deal with the various effects of COVID-19 – such as the promising data for interleukin-6 [IL-6] therapies. Instead, while data remain very scant because of the early stages of development, we are more interested in the development of “antibody cocktails” such as those being developed at Regeneron (US) and Vir (US).
“IHS Markit has evaluated current evidence and status for a selection of promising medicines, together with current high-profile anti-virals, that are under evaluation for COVID-19 infection and its complications. Most of the drugs under the closest scrutiny currently are repurposed versions of existing medicines that have established safety profiles and could be approved relatively quickly, once the evidence base is confirmed to be adequate. Medicines that are currently receiving EUAs are highly likely to be superseded by more effective products – some with similar mechanisms – as results from controlled trials become available.”
- Gustav Ando, Head of life sciences and industry services, IHS Markit
High-profile candidate therapeutics in development for COVID-19 and its complications anti-virals
Direct anti-virals |
|
Drug Name |
Mechanism |
Remdesivir |
Selective viral RNA replicase inhibitor |
Avigan (favipiravir) |
Selective viral RNA replicase inhibitor |
Chloroquine, hydroxychloroquine (Plaquenil and generics) |
Antiviral mechanism uncertain |
Neutralising antibodies |
|
Drug Name |
Mechanism |
Convalescent plasma, including polyclonal hyperimmune globulins |
Convalescent serum is expected to contain neutralising polyclonal antibodies with potential activity against COVID-19 antigens |
LY-CoV555 |
Neutralising IgG1 MAb specific for COVID-19 spike protein |
Other neutralising MAb monotherapies or cocktails |
Neutralising antibodies against specific COVID-19 antigens (various strategies) |
Treatments for complications |
|
Drug Name |
Mechanism |
Actemra (tocilizumab) |
Interleukin-6 (IL-6) inhibitor |
Kevzara (sarilumab) |
Interleukin-6 (IL-6) inhibitor |
Kineret (anakinra) |
IL-1 type-1 receptor antagonist |
Calquence (acalabrutinib) |
BTK inhibitor |
Farxiga/Forxiga (dapagliflozin) |
SGLT2 inhibitor |