The Briefing provides an at-a-glance view of some important developments in the information universe surrounding COVID-19. The views presented here are solely those of ECRI Horizon Scanning and have not been vetted by other stakeholders.

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Drugs modeled on natural immune responses to viruses are taking center stage in the fight against COVID-19 (see Topics to Watch). The National Institutes of Health (NIH) announced a phase 2 trial investigating the antibodies risankizumab (Boehringer Ingelheim) and lenzilumab (Humanigen).

These treatments show promise, but obstacles remain. Eli Lilly’s antibody trial was paused on October 13, 2020, due to safety concerns. Researchers are investigating to determine whether the safety issues are related to the treatment group or the placebo group.

Short supply and high costs could pose additional obstacles. Regeneron estimates that enough doses to treat up to 300 000 patients with REGN-COV2 will be available in coming months. But, this might not be enough, given the number of COVID-19–related hospitalizations in the United States. Less expensive, widely available treatments, such as colchicine (see Topics to Watch), might reach more people; however, the disparities in care that many are already experiencing could increase if expensive treatments with limited availability turn out to be more effective.

Colchicine to Treat Patients Hospitalized with COVID-19

At a Glance

  • Colchicine is an oral drug approved for treating gout and familial Mediterranean fever that is being investigated for treating COVID-19 because of its purported anti-inflammatory and antiviral properties.
  • An open-label, phase 2 clinical trial conducted in Greece found that colchicine treatment added to standard care provided a longer time before patients’ symptoms worsened, compared with standard care alone. A cohort study also found that hospitalized patients given colchicine and standard care were about 5 times as likely to be discharged and more than 3 times less likely to die, compared with standard care.
  • Colchicine is being investigated in 4 ongoing clinical trials in the United States, including a trial enrolling about 6000 outpatients, with primary study completion expected in December 2020.
  • One course of colchicine for treating COVID-19 costs about $80 to $150.

Monoclonal Antibodies Targeting the SARS-CoV-2 Spike Protein for Treating COVID-19

At a Glance

  • Laboratory-grown neutralizing monoclonal antibodies target the coronavirus spike (S) protein, responsible for virus binding and entry into host cells. Treatment with these neutralizing antibodies might confer short-term, passive immunity against coronavirus infections, improving patient outcomes.
  • Preliminary results from Eli Lilly found that nonhospitalized patients given neutralizing antibodies plus standard care had lower virus counts at day 11 and a lower hospitalization rate, compared with placebo plus standard care through day 29. Also, treatment with a cocktail of 2 antibodies reduced virus counts, improved symptoms, and reduced COVID-related hospitalization and emergency room visits, compared with placebo plus standard care.
  • Regeneron reported nonhospitalized patients without detectable plasma coronavirus antibodies before treatment gained the most. These patients experienced reduced virus counts, shorter time to symptom alleviation, and fewer medical visits when given a 2-antibody cocktail, compared with placebo.
  • Eli Lilly and Regeneron have submitted requests to the FDA for emergency use authorizations for LY-CoV555 monotherapy and REGN-COV2 dual-antibody treatment.

Commentary in this COVID-19 Scan reflects preliminary views of ECRI Horizon Scanning and internal ECRI stakeholders.
The information contained in this document has not been vetted by other stakeholders.

We welcome your comments on this Scan. Send them by email to [email protected].

Posted: October 20, 2020

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