Drugs to help tamp down the immune system’s over-reaction in COVID-19 are showing promise and could help prevent hospital deaths.
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People who die of COVID-19 aren’t killed directly by the virus. It’s often because their immune systems overreact to the coronavirus. So scientists have been looking for drugs to try to tamp down this reaction. As NPR science correspondent Richard Harris reports, some companies report encouraging findings.
RICHARD HARRIS, BYLINE: Doctors generally employ a two-pronged attack to treat COVID-19. Raj Gandhi, an infectious disease doctor at Massachusetts General Hospital, says the first step is to use drugs like monoclonal antibodies to block the virus to prevent people from needing to go to the hospital.
RAJ GANDHI: Now, if they don’t work and people do get sicker and they get hospitalized, that’s when we think the immune response, the inflammation, kicks in.
HARRIS: And that can be deadly. Doctors last year recognized that a cheap and readily available steroid drug called dexamethasone can control inflammation. In fact, it’s the only COVID-19 drug so far that clearly saves lives.
GANDHI: Dexamethasone is a really powerful anti-inflammatory. There are still people who need more.
HARRIS: A couple of anti-inflammatory drugs that were developed to treat rheumatoid arthritis are sometimes used either instead of or in addition to the steroid. But there’s also a race to come up with something more. This week, Humanigen announced in a press release that its drug reduced the risk that someone with COVID-19 would need to be put on a ventilator. Dr. Cameron Durrant is president and CEO.
CAMERON DURRANT: You really don’t want to be in the ICU. You don’t want to be on a ventilator. You don’t want to be in a hospital bed. And so potentially offering something that gets patients out faster is really what we’re all striving for.
HARRIS: Durrant says that based on this study of about 500 patients, the company plans to ask the Food and Drug Administration to grant emergency authorization for its drug.
DEREK LOWE: They made a big deal out of – the stock went up quite a bit.
HARRIS: Derek Lowe is a pharmaceutical researcher who writes a related blog called In the Pipeline.
LOWE: But the press release was not as informative as it could be.
HARRIS: And on reflection, that left both investors and scientists wondering whether the data are really good enough to merit a quick thumbs-up from the FDA. A second company’s excited press release about a similar drug also left Lowe and other experts unsure what to make of the results. Whatever the case, he doubts these drugs, which are likely to be very expensive, will replace cheap and readily available steroids as the first drug of choice.
LOWE: You would figure more expensive, more targeted sorts of inflammation drugs like this are going to be second and third line. It’s like, OK, they’re not responding. Let’s try something else. I think they’re going to help some, but they’re not going to be game-changers.
HARRIS: Vaccines are the game-changers. And as more and more people get vaccinated, fewer will end up in the hospital needing intensive care, Lowe says.
LOWE: It’s a paradox because these are the sort of expensive drugs in many cases that would be found in wealthy industrialized countries. But the wealthy industrialized countries are going to be the ones that have a higher percentage of people vaccinated with fewer patients who are even going to need them.
HARRIS: One other challenge is these potential products are all rushing to market and haven’t been tested against one another. It’s not clear which one might be better. Dr. Gandhi at Mass General says doctors also need to figure out the best way to combine them with other drugs to treat COVID-19.
GANDHI: And is it safe to combine them with other anti-inflammatories? Many of these anti-inflammatory suppress the immune system, and so you want to make sure that you don’t have extra side effects if you combine drugs.
HARRIS: In normal times, these kinds of questions would be studied more slowly and methodically. But these aren’t normal times. So if any of these drugs gets emergency authorization, there will still be a lot of lingering questions about them. Richard Harris, NPR News.
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