The anti-Covid monoclonals market hots up a bit more

[bennevisplace]

This is an update to my previous post giving results for the phase 3 trial (COMET-ICE) of monoclonal antibody cocktail Sotrovimab administered by intravenous infusion healthunlocked.com/cllsuppo...

Now the COMET-TAIL phase 3 trial has demonstrated that the drug is almost as effective when given by intra-muscular injection gsk.com/en-gb/media/press-r...

This article fiercepharma.com/drug-deliv... sets Sotrovimab's latest success in context.

"AZ’s [Astrazeneca's] current EUA request for AZD7442 [Evusheld], filed in early October, is for prophylaxis use to prevent symptomatic COVID.

Intramuscular injection would be a more convenient administration route, but Regeneron’s COVID combo REGEN-COV already has an EUA for an under-the-skin formulation, which is authorized for use within three days of a positive COVID test [the drug is also authorised in the EU and the UK where it is known as Ronapreve].

The antibody drugs may have a smaller market now that Pfizer is seeking FDA EUA for its oral antiviral Paxlovid after the compound cut the risk of hospitalization or death by 89% in high-risk nonhospitalized patients. The treatment window was three days post-symptoms, but Pfizer said the drug showed similar results when given within five days of symptom onset.

Despite the convenience and big efficacy showing of oral antivirals, SVB Leerink analyst Geoffrey Porges recently noted that antibodies might have a role to play in the prevention market and may have an edge for treating people longer into a symptomatic infection".

[LeoPa]

Which one is the best? Casirivimab, Imdevimab or Sotrovimab?

[bennevisplace in reply to LeoPa]

Don't know Leo, but I would take either one, either way.

The first two you mentioned are the components of REGN-COV2 aka Ronapreve, which trials suggest is pretty effective not only as early stage treatment but also as a long acting prophylaxis (surprisingly up to 8 months).

Sotrovimab also fared well in trials but AFAIK has not been tested as a long acting prophylactic. It may be more resistant to viral escape by variants. An interesting trial ongoing partners Sotrovimab with another MAb, VIR7832, the latter being engineered for potent antibodies and stimulating T cell response. agiletrial.net/first-patien...

[Palmetto]

You only need to be exposed to Covid and not actively have Covid and still get the Regeneron injections.

[bennevisplace in reply to Palmetto]

Yes I believe that's the case Stateside, and I see that you yourself had Regeneron after being exposed to Covid in the home.

In the UK Regeneron presents something of an assault course:

1. report symptoms, justifying

2. a PCR test, which if positive leads to

3. you being medical assessed as at-risk of severe disease, which qualifies you for

4. a test for antibodies, which if negative makes you a candidate for Regeneron.

Then, if your hospital has the drug in stock and your attending physician is au fait with its use, you should get it.

WHAT??? I hear you say, but by the time you've had all that done you could be beyond help from antibodies. And you'd be right.

[Palmetto]

Actually I did not have Regeneron although they offered it to me. It is my husband with CLL and although I am over 65 I don't have any serious medical issues and feel that the vaccines were probably successful for me, although if I ever do actually get Covid I will head straight away for Regeneron. We are lucky to live close to the location here in Miami. I am so sorry that the UK has not put this more in the forefront. Stay safe.

[bennevisplace in reply to Palmetto]

Thanks, and same to you and your husband.