Regeneron: Antibody 'cocktail' given to Donald Trump could be used by NHS
16 June 2021, 09:57
Severely ill coronavirus patients could be offered the same antibody 'cocktail' given to former US President Donald Trump after a UK trial found it can save lives.
Researchers on the Recovery trial found that a drug combination developed by pharmaceutical giant Regeneron reduced the overall risk of death when given to patients who had not begun a natural antibody response of their own.
The chances of Covid-19 patients with severe disease needing to be put on a ventilator were also reduced, as was the duration of their hospital stay.
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Almost 10,000 UK patients admitted to hospital with the disease were randomly allocated to receive the antibody combination treatment in addition to usual hospital care - or were given usual care alone - between September 2020 and May this year.
According to the study, the chance of death within 28 days in people who had no antibody response was reduced by a fifth after they received the treatment.
Estimates suggest for every 100 such patients treated with the antibody combination, there would be six fewer deaths.
Researchers also found the death rate was twice as high in those without an antibody response (30%) who received usual care alone, compared with those who were seropositive (15%) at the start of the study.
Sir Martin Landray, professor of medicine and epidemiology at the Nuffield Department of Population Health, University of Oxford, and joint chief investigator, said: "What we found was amongst these patients who were seronegative - they hadn't raised antibodies of their own, if you then gave them this combination of two antibodies in an intravenous infusion, then mortality was reduced by one fifth.
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"So instead of 30% dying, 24% died. So if you think of it differently, for every 100 patients who were given the intravenous infusion, we would save six lives."
He added: "Take a group of people, they're sick, they go into hospital, they've got Covid, they haven't got antibodies of their own, (this) will reduce their chance of dying, shorten their hospital stay, and reduce the chances of needing a ventilator."
Of those who took part, about one third were seronegative, meaning they had no natural antibody response of their own, and half were seropositive, meaning they had already developed natural antibodies against the virus.
For one in six participants, their serostatus was unknown.
For the seronegative patients given the treatment, the duration of hospital stay was four days shorter than the usual care group, and the proportion of patients discharged alive by day 28 was greater - 64% compared to 58%.
But the treatment made no difference in patients who had mounted their own antibody response by the time the study started, researchers found.
Sir Peter Horby, professor of emerging infectious diseases at the University of Oxford, and joint chief investigator for the Recovery trial, said: "These results are very exciting. The hope was that by giving a combination of antibodies targeting the Sars-CoV-2 virus we would be able to reduce the worst manifestations of Covid-19.
"There was, however, great uncertainty about the value of antiviral therapies in late-stage Covid-19 disease.
"It is wonderful to learn that even in advanced Covid-19 disease, targeting the virus can reduce mortality in patients who have failed to mount an antibody response of their own."
Researchers say they are not sure when the treatment will be approved for use in the UK and highlight it will not be a quick rollout as with other treatments due to the low availability of the drug.
Patients would also need antibody testing on their admission to hospital - not currently in place - as part of the treatment.
Responding to the results, Professor Stephen Powis, national medical director for NHS England, said: "These encouraging results from this trial carried out in and by the NHS suggest a new treatment option to help save the lives of some patients hospitalised with Covid and are the latest example of research and innovation for patients, which the NHS has played a role in during the pandemic.
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"Studies have also suggested the same treatments might help similar patients in the community avoid going to hospital in the first place, which is why yesterday the health service chief executive, Sir Simon Stevens, asked the NHS to rapidly establish a new monoclonal antibody service so we are ready to offer these drugs if backed by regulators."
The treatment uses a combination of two monoclonal antibodies (casirivimab and imdevimab, known as REGEN-COV in the US) that bind specifically to two different sites on the coronavirus spike protein, neutralising the ability of the virus to infect cells.
Previous studies showed the treatment reduced viral load, shortened the time to resolution of symptoms, and significantly reduced the risk of being admitted to hospital or death.
