Gilead's Remdesivir Tested With Other Drugs to Fight Covid-19
May 13 2020 - 5:59AM
Dow Jones News
By Joseph Walker
The promise and limitations of remdesivir, the first drug to
prove capable of helping fight Covid-19, have kicked off efforts to
see if it can work better in combination with other treatments and
to create new, easier methods of administering it.
Researchers are exploring whether the drug, made by Gilead
Sciences Inc., can be combined with other antiviral treatments to
make a more potent coronavirus-fighting cocktail.
Six Covid-19 drug trials currently under way specify testing
remdesivir with another medicine, according to Informa Pharma
Intelligence. Another five trials are of drugs that would be given
in tandem with whatever a hospital uses as standard treatment --
which increasingly means remdesivir.
Gilead is also studying new formulations of remdesivir so
patients can take it outside of a hospital.
Remdesivir, originally aimed at treating Ebola, has emerged as
the go-to Covid-19 treatment. Federal health regulators quickly
authorized its emergency use May 1, after it proved effective in a
large, rigorously-designed study. Hospitals are lined up for
doses.
But the drug isn't a silver bullet. So far at least, it has
shown to be only modestly effective in treating a sliver of very
sick patients.
Remdesivir's standard use in Covid-19 treatment "can be
misleading because it suggests this is very, very good therapy, but
it isn't," said Anthony Fauci, director of the National Institute
of Allergy and Infectious Diseases.
"It's standard because it's better than nothing," Dr. Fauci
said.
Development of HIV drugs in the 1980s proceeded on a similar
path, with researchers in the 1980s building upon the early but
limited success of the first agent to develop progressively better
treatment regimens.
In its key clinical trial, remdesivir shortened the recoveries
of hospitalized patients by four days compared with a placebo. The
seriously-ill patients still spent an average of 11 days in the
hospital. NIAID supported the study.
Moreover, the drug's use is limited to the hospital because it
has to be administered with an intravenous infusion.
A number of studies are under way exploring how to make
remdesivir's impact stronger by pairing it with a separate drug
that tamps down on the overactive immune response, known as a
cytokine storm, triggered in some infected patients.
Drug researchers want to see whether an arthritis drug, for
example, can beat back the cytokine storm, while remdesivir stops
the virus from replicating itself inside the lungs. Certain
arthritis drugs reduce inflammation.
"That's the ideal situation for me, where you have combinations
of drugs that are doing multiple jobs to holistically attack the
disease," said Timothy Sheahan, assistant professor of epidemiology
at the University of North Carolina, who has helped conduct
laboratory tests of remdesivir in coronaviruses.
Researchers conducting NIAID's trial of the drug are now testing
it in combination with Eli Lilly & Co.'s arthritis therapy
baricitinib, which is sold under the brand name Olumiant.
A study evaluating arthritis drug Actemra, from Roche Holding
AG's Genentech unit, will include subjects taking remdesivir as
part of their care, said Mark Eisner, a senior vice president at
Genentech overseeing Actemra's clinical development.
Researchers are unsure whether there will be enough supply of
remdesivir to include it in all trials going forward, Dr. Eisner
said. "It's a question that all of the clinical trial investigators
have now," he said.
Gilead, based in Foster City, Calif., is working on new ways to
administer the drug outside of the hospital and whether it can be
combined with other antivirals to make a more potent virus-killing
cocktail.
The company is developing an inhalation device so patients can
suck the drug into their respiratory tracts. The company is also
trying to make a prefilled syringe that can be injected into the
skin at home.
If the new formulations pan out, they could be used to test
remdesivir in patients who aren't in the hospital, Gilead Chief
Medical Officer Merdad Parsey said last month.
Write to Joseph Walker at joseph.walker@wsj.com
(END) Dow Jones Newswires
May 13, 2020 05:44 ET (09:44 GMT)
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