How Virus Antibody Drugs Work (In Theory)

Source: Business Insider

Over the weekend, U.S. president Donald Trump, his wife Melania Trump, and former New Jersey governor Chris Christie announced that they have tested positive for the Covid-19 coronavirus and have begun isolating.

Trump’s age (74) and weight puts him at an increased risk for a more serious case of the disease. He will be at Walter Reed National Military Medical Center for several days. White House physician Sean Conley said Trump has received an injection of 8 grams of Regeneron’s experimental antibody drug, which is a combination of two antibodies and called REGN-COV2. How is antibody medication developed?

In response to detecting an invading threat, the human body’s immune system produces virus-fighting proteins called antibodies. In this case, that invader is the coronavirus, which infects cells and hijacks them to produce more of the virus.

Our bodies pump out tons of customized antibodies to fight back and stop the virus. To make a virus therapeutic, a large pool of antibodies is collected and sorted through to find the most potent ones for fighting the coronavirus.

These often come from blood donations from recovered COVID-19 patients or from testing animals. The donated plasma full of antibodies is injected into sick patients. The approach requires lots of recovered blood donors — making it difficult to scale — and has not yet been proved effective for this pandemic, despite securing an emergency approval from the FDA.

Early studies from France and China appeared to show promisde that the drug hydroxychloroquine worked, encouraging many doctors, as well as Trump himself. The Food And Drug Administration (FDA) issued an emergency approval to treat hospitalized patients in late March. However, the initial findings were severely flawed by the limitations of the studies.

The trials enrolled tiny groups of patients, or lacked a control group against which to compare the results. Studies that enrolled more people and tested the pills against a placebo group consistently found no benefit for hydroxychloroquine.

The negative trial results, which have been published in top peer-reviewed medical journals, found hydroxychloroquine didn’t prevent COVID-19 in people exposed to the virus, nor did it help hospitalized patients recover faster. In June, the FDA revoked the emergency-use authorization for hydroxychloroquine and chloroquine. A top-ranking government official later said there was political pressure put on the agency to green-light the drug.

The FDA has given emergency-use authorization to two coronavirus treatments: the antiviral remdesivir and convalescent plasma. In addition, the steroid dexamethasone has shown promise in patients with acute infections.

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