President Donald Trump is promising the FDA will quickly authorize antibody treatments to help fight off Covid-19, highlighting his support for the experimental treatments as a vaccine increasingly seems unlikely before Election Day.
Trump is calling the monoclonal antibody treatment he received from Regeneron for his coronavirus infection a "cure," vowing to make it freely available to all Americans stricken with the virus. However, there’s little data on the effectiveness of these treatments — which mimic the body’s natural defenses against infection — for Covid-19 patients, and there are likely to be shortages.
What the data shows: Regeneron has only released some preliminary data from one of its late-stage trials in which 275 people received the treatment. It showed that the treatment may reduce viral load and hasten recovery, but it’s not clear whether the drug reduces the risk of death. Eli Lilly, which also is conducting multiple late-stage trials on a similar treatment, has released partial findings from a study showing its therapy may reduce virus levels and possibly help with symptoms.
How quickly could approval come: Regeneron said it requested an emergency authorization from FDA just hours after Trump touted the antibody cocktail in a video Wednesday afternoon. Lilly said it sought authorization earlier on Wednesday.
Trump, who has put unusual pressure on FDA to quickly approve coronavirus treatments and vaccines, is now vowing federal regulators will green-light antibody therapies from both companies.
“Emergency use authorization is all set, and we gotta get it signed now,” Trump said in the Wednesday video.
It’s not clear how quickly FDA will decide on either company’s application for an emergency use authorization, but this raises another inflection point for an agency that has seen its independence challenged by political pressure during the pandemic. The FDA previously provided emergency use authorizations for two treatments touted by Trump — hydroxychloroquine and convalescent plasma — despite scant evidence of their effectiveness. The FDA later revoked the hydroxychloroquine authorization after rigorous trials found the anti-malarial didn’t work on Covid-19 patients.
An early emergency use authorization for antibody treatments could also make it difficult for companies to attract volunteers for clinical trials that could prove whether they work and at what dosage. That has been a concern for ongoing convalescent plasma trials after FDA provided an emergency authorization about six weeks ago.
There’s likely not enough drug for everyone: In the upbeat video posted by the White House on Wednesday evening, Trump promised he would provide antibody treatments free for every American. But experts are predicting shortages of the treatments, which are costly to produce, and few manufacturing facilities are equipped to make them.
Operation Warp Speed, the Trump administration program speeding coronavirus vaccines and therapeutics, has provided $450 million to Regeneron to supply as many as 300,000 doses for Americans at no cost before the end of the year. It’s unclear how the next doses will be distributed or what they might cost. Regeneron struck a deal with Roche this summer to boost manufacturing capacity, but the company hasn’t provided specific production goals.
Lilly has said it could supply as many as 1 million doses of its treatment before the end of the year, but it’s unclear if all those doses would be reserved for the U.S. or if Warp Speed would purchase them to provide to Americans at no cost.
Warp Speed officials are hoping that the antibody treatments can be rolled out quickly and act as a bridge to vaccines. It will likely take months to widely distribute a coronavirus vaccine, even if one gains approval before the end of the year.
Vaccine politics: Trump has conceded that a vaccine is unlikely to be authorized before the Nov. 3 election after this week’s release of FDA guidance toughening standards for emergency approval. The White House for weeks had opposed the guidance, which Trump has claimed without evidence was part of a political plot within FDA to prevent a vaccine approval before the election.
"I think we should have it before the election but frankly the politics gets involved and that’s okay,” Trump said. “They want to play their games, it’s going to be right after the election.”
Of the four vaccine candidates in late-stage U.S. trials, only Pfizer says it’s possible to know if its vaccine works by the end of October. FDA’s top vaccine official Peter Marks said Wednesday that he thinks a vaccine may be ready in November or December.
What’s next: FDA in a statement said it wouldn’t comment on the pending applications for antibody treatments, citing agency policy. Investment analysts predict that an emergency authorization could come sometime between next week and the end of the year.
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