The Oxford-based Recovery trial which proved that steroids saved the lives of some Covid patients will now take on a promising but far more expensive new antibody combination treatment, it has been announced.
A cohort of patients joining the trial in most NHS acute hospitals will be randomly allocated to Regeneron’s experimental drug, called REGN-COV2. The drug is a combination of two human neutralising antibodies against the virus. The company previously developed a similar antibody drug against Ebola.
Unlike dexamethasone, which Recovery proved saves the lives of one in eight acutely ill patients, this is a drug that has been invented for the pandemic. It has successfully come through animal studies and a phase 1 safety trial and is now in late stage trials in the United States.
Peter Horby, professor of emerging infectious diseases and global health at Oxford University and chief investigator of the trial, said: “We have already discovered that one treatment, dexamethasone, benefits Covid-19 patients, but the death rate remains too high so we must keep searching for others. The Recovery trial was specifically designed so that when promising investigational drugs such as REGN-COV2 became available they can be tested quickly. We are looking forward to seeing whether REGN-COV2 is safe and effective in the context of a large-scale randomised clinical trial; this is the only way to be certain about whether it works as a treatment for Covid-19.”
Martin Landray, deputy chief investigator of the trial and professor of medicine and epidemiology said: “Up to now, we have largely been studying whether existing drugs can be re-purposed to tackle this new disease, but we now have the opportunity to rigorously assess the impact of a drug specifically designed to target this coronavirus. There are good reasons to be excited about this new development – Recovery will provide a robust assessment of the effect of this lab-manufactured monoclonal antibody combination treatment in hospitalised patients.”
Deputy chief medical officer Jonathan Van Tam said the Recovery trial was globally recognised as the most successful in the world. “Today’s news is another promising step in the search to find effective treatments, which will improve our ability to deal with this destructive virus, and a testament to the confidence that others around the world have in this brilliantly conceived and executed trial.”
But while dexamethasone, a very old drug and well out of patent, costs around £5 to treat a patient, there will be questions over the affordability of the new antibody cocktail, if it works.
“Novel antivirals and monoclonal antibodies are among the most exciting and promising treatments for Covid-19 because they are specific to the disease, but they are also traditionally the most expensive,” said Nick Cammack, Covid-19 therapeutics accelerator lead at Wellcome.
“Large-scale randomised controlled studies like Recovery give us the best understanding of whether drugs like REGN-COV2 are safe and effective against Covid-19, but we must ensure that any successful treatment is available to everyone who needs it globally.”