Besremi for Covid and a different type of IFN-α 2b in Covid treatment trial

[EPguy]

The Besremi guys did a small trial that reduced time to negative covid PCR test to 7 from 11.5 days

ncbi.nlm.nih.gov/pmc/articl...

They mention a phase 3 but it seems no further action.

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There is a larger trial using an inhaled INF ( IFN-α 2b) as a treatment for infection. IFN-α 2b is the type that is in Besremi (PEG uses 2a, if it makes any difference)

clinicaltrials.gov/ct2/show...

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It brings the question whether INF patients here who get Covid are getting any "treatment for infection" on INF.

Maybe it can help with protection but maybe also can lead to more vax reactions we may be seeing here?

Of course we don't have answers, but it would be nice if INF has another benefit.

[Loubprv Volunteer]

That’s great for the US but sadly Besremi isn’t available on the NHS here in the uk.It’s available here at £52,000 per annum !!

[EPguy in reply to Loubprv]

52,000 is hopeless. But if there's anything to it, PEG should have similar benefit.

[kristinmarie in reply to Loubprv]

According to the following link, besremi failed to demonstrate non-inferiority to hydroxycarbamide, and therefore was not recommended.scottishmedicines.org.uk/me...

This may be blessing in disguise; for many, interferon as PV treatment is inferior to hydroxycarbamide. No big loss.

[EPguy in reply to kristinmarie]

That is big news for Scotland members. I read the detailed reject letter briefly. My summary is they don't want to pay.

For those who can tolerate INF, the average advantage for allele reduction is large vs HU. see the familiar plot in my 2nd reply. But this benefit is not yet fully accepted in the profession. The 5 year Ropeg showed CHR advantage also.

Some details:

-They seemed to stop the comparison at 12 months, INF never looks good over that short period. <<In PROUD-PV, non-inferiority of ropeginterferon alfa-2b to hydroxycarbamide was not shown for the primary outcome at month 12>>

-Suspiciously the table below ignored the 3 year data (see * sections); I know most of it is easily available.

-They complain there was no comparison to PEG. True. Is PEG covered by Scottish plans? If not then they are really out of touch. It is effective for many we see here and in clinical studies.

-Molecular response was not an official end point so it's not high on the advantage list, but anyway at 12 months it won't show (HU actually looks better at 1 year, see my 2nd reply here)

Scotland RopegReject

[EPguy in reply to kristinmarie]

Ropeg vs HU alle reductions. The Scottish rejection seems to have looked only to 12 months.

Ropeg5+Years

[Orangeboykitty]

I've been on Besremi for 6 months but have had covid twice....or maybe it never left the first time. I never tested positive but knew what it was after I lost my sense of smell. I also never had a fever, just a nasty lingering cough. So for me there wasn't any protective benefit at all.

[EPguy in reply to Orangeboykitty]

If you tested and stayed negative it suggests your viral load stayed small, and your non-severe symptoms are consistent with a low load. But why that happened is the billion dollar question. It is strange that Covid does not cause fever in many/most cases, the temp checks were never of much value so we don't see them anymore.

Our responses to Covid and INF are much too varied to know outside of clinical trials, similar as with many of our MPN treatments. Shame these things are not simpler.

I never tested positive either, but there were no tests when I had it. We had moderate/severe cases.

The small Bes vs Covid trial was not enough to show a benefit, only a reason to do more. But the larger inhaled trial suggests there could be something to INF vs Covid. Will be interesting to see the results.

[FG251]

I wondered whether my PEG was beneficial when I caught Covid in May, five months after commencing treatment. I just had a blocked nose for a week - that was it - and I hadn’t even had the booster. The first time I caught Covid, last November, I was still on HU. It was more like a flu-type cold, but nothing too serious. I began to wonder if immunotherapy on IFN boosts the whole system…?

[EPguy in reply to FG251]

Our responses to Covid and INF are so varied that only the controlled trials can tell, same as with the vaxs and treatments. But with such INF trials happening the experts seem to think there's

something to it as the small trial pointed. But it seems the injectable

INFs are not being tested at this point, only the inhaled one.

Your Nov infection is protective, we get protection from either vaxes or infection. I recently posted brief info on boosters and prior infection. Vaxes are just very low (not zero) risk way to get that protection without risk of long covid etc. The authorities prefer to de-emphasize infection protection since they want to encourage getting vaxed (I understand that) Full info gets complicated. (I'm infection + 3 vaxed)

Interesting they are looking to inhaled drugs. It is also considered the best way for vaxes to actually prevent Covid infections vs the narrower current vax purpose to much reduce odds of bad outcomes. I've read there are at least 3 phase 3 trials on inhaled vaxes now.