As expected in these life-threatening times, the pharma companies respond by doing what they do best: research and development.
The immediate pharma company responses to the outbreak of the respiratory disease COVID-19, caused by the newly discovered coronavirus, include identifying known drugs which may be used to treat the virus, development of new drugs, and the potential for vaccines against the disease.
Here’s where we are now and what the future may hold:
Known drugs for treatment
There’s no doubt about it; the identification of a drug or drug combination which is already authorised for the market provides a huge jumpstart for treatment. It is therefore a “no-brainer” in the current environment to consider what drugs might be useful. The key identifiers for success are whether the drug reduces mortality rates, reduces patient time in hospital or reduces the need for patient ventilation or intensive care units. Where any of these are shown, at least some success can be claimed. The comparison must be against the current standard of care, which is currently pain relief, rest, cough medication and fluid intake.
Known drugs and drug combinations currently being reviewed/tested are based on knowledge of mechanisms of action of the drug and/or similarly the known physiology of the disease and include:
The hypertension drug losartan
The antiviral drug remdesivir
Combined HIV drugs lopinavir and ritonavir (with and without interferon beta)
The antimalarial drug chloroquine
The antimalaria, lupus and rheumatoid arthritis drug hydroxychloroquine
Combined hydroxychloroquine and antibacterial drug azithromycin
The flu drug favilavir
The blood clot drug nafamostat
Combined flu drug oseltamivir with antihistamine drug chlorophenamine
The drugs and combinations are being reviewed on a critical needs basis. Indeed, the need is so much in demand that The World Health Organisation (WHO) has announced a multi-country clinical trial for potential therapies. Ten countries have already indicated that they will take part. In addition to the WHO announcement, further drugs are being tested in patients in various countries, with a view to identifying ways to treat the disease. Other known drugs and combination will likely be added to the list going forward with the potential that at least one option will assist clinicians in some progress to treating the disease, perhaps until other new specific drugs and treatments are identified.
New drugs for treatment
Getting a new drug to market can take many years, although the current urgent need to treatments may enable fast tracking of potential new drugs. In view of the current patient population, treatment is highly desired as well as vaccination. Companies already looking to develop new treatments include:
I-Mab Biopharma with a neutralising antibody to reduce acute and chronic inflammation
Airway Therapeutics with a recombinant protein to reduce inflammation and infection in the lungs
Tiziana Life Sciences with an anti IL-6R monoclonal antibody to prevent lung damage
OyaGen with a previous anti-cancer drug, now showing antiviral activity
University of British Columbia and APEIRON Biologics with an ACE2-directed drug to reduce viral load
Innovation Pharmaceuticals with a drug currently in evaluation for IBD and mucositis
CytoDyn with a drug currently under evaluation for HIV treatment
More will undoubtedly follow.
Potential for vaccines
In many cases, prevention is better than cure, and thus the development of a vaccine is a highly desirable objective. Vaccine opportunities are currently being researched by at least the following companies:
Tonix Pharmaceuticals, BeyongSpring, Inovio & Beijing Advaccine Biotechnology, Altimmune, Medicago, MIGAL Research Institute, Moderna & Vaccine Research Centre, Clover Biopharmaceuticals, Vaxart and Novavax.
We wish all the above companies, and others, speed in identifying potential treatment and preventative measures.
In time, the IP afforded to these drugs may influence which become longer-term commercial successes, developed for future generations. But for now, any improvement for prevention or treatment better than the current standard of care will be a significant contribution to society.
We will follow these potential drugs and vaccines as they develop.
If you have a question please contact your usual Kilburn & Strode adviser.