mAbs shine after use in Covid treatment of US President

Move over hydroxychloroquine; it seems to be mAbs’ (or monoclonal antibodies) day it the sun, thanks to US President Donald Trump, who is being treated for Covid-19.

Even as reports remain unclear as to whether President Trump will leave the hospital on Monday, what is now clear is that he was reportedly given a combination of experimental drugs, including mAbs and antiviral Remdesivir, besides a long-known corticosteroid, dexamethasone. But unlike the other therapies and vaccines that have received much attention, mAbs have a less public profile. They are, however, clearly on the scientific radar of many companies – from Regeneron Pharmaceuticals Inc that provided the US President the drug to AstraZeneca and Eli Lilly.

Long-term effects

Dr Suranjit Chatterjee, a senior internal medicine consultant with Delhi’s Indraprastha Apollo Hospital, explains that monoclonal antibodies are “neutralising antibodies” that are injected into the body to help fight the infection. In this case, it is given at an early moderate stage of the infection, and is reported to be beneficial, he said, adding that it was still early days and the long-term effects of the drug are yet to be mapped.

Biological in nature, mAb products find much use in immunological diseases and cancers, he said, addingthat it was an expensive product as it was difficult to produce.

Indian drug companies also make mAbs for various conditions. But Bharat Biotech is helming a project to develop human monoclonal antibodies as therapy for Covid-19 infections. The project had been sanctioned by the Council of Scientific and Industrial Research under its new millennium technology initiative.

The attention on mAbs has spiked recently, given the Trump-connection, just as in the early months of Covid-19 the spotlight was on anti-malarial and rheumatoid arthritis drug hydroxychloroquine after the US President touted it as a magic-pill of sorts.

Despite mAbs’ new found attention, doctors say it is unlikely to take the shine away entirely from Covid-19 vaccine candidates, since they play a more preventive role.

mAbs for the President

Late last month, Regeneron Pharmaceuticals shared the first data from a descriptive analysis of what it called “a seamless Phase 1/2/3 trial” of its investigational antibody cocktail REGN-COV2. The analysis revealed “it reduced viral load and the time to alleviate symptoms in non-hospitalszed patients with Covid. REGN-COV2 also showed positive trends in reducing medical visits,” the company said.

The trial was part of a larger program that also included studies of REGN-COV2 for the treatment of hospitalised patients, and for prevention of infection in people who had been exposed to Covid-19 patients.

A key concern with therapies that target SARS-COV2 (the virus that causes Covid-19) is that it exacerbates the immune response. George D Yancopoulos, President and Chief Scientific Officer of Regeneron, however, pointed out: “The greatest treatment benefit was in patients who had not mounted their own effective immune response, suggesting that REGN-COV2 could provide a therapeutic substitute for the naturally-occurring immune response.”

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