Health & Wellbeing

What do we know about Trump's experimental COVID-19 "cure"?

What do we know about Trump's ...
One of several treatments Donald Trump received for COVID-19 was an experimental antibody cocktail called REGN-COV2
One of several treatments Donald Trump received for COVID-19 was an experimental antibody cocktail called REGN-COV2
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One of several treatments Donald Trump received for COVID-19 was an experimental antibody cocktail called REGN-COV2
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One of several treatments Donald Trump received for COVID-19 was an experimental antibody cocktail called REGN-COV2

On October 8th 2020, Donald Trump returned to the White House after spending several days at the Walter Reed Medical Center receiving a number of treatments for COVID-19. In a video message published on Twitter the President attributed his rapid recovery to a new experimental therapy he called "Regeneron" which he subsequently referred to as a “cure”. What do we know about this new experimental drug? Is it safe? And what does it actually do?

What is it?

The drug is one of the first COVID-19 specific treatments to be developed. It is called REGN-COV2, and it is produced by pharmaceutical company Regeneron.

It is a monoclonal antibody “cocktail” combining two potent but complimentary lab-engineered antibodies designed to rapidly stop the virus from replicating inside an infected patient.

What is the evidence it works?

REGN-COV2 is still deeply experimental. The only peer-reviewed and published data on the therapy can be found in a pair of journal entries published over the last few months outlining the preclinical results of animal tests.

At the end of September, Regeneron sent out a press release touting the therapy’s efficacy in its initial human trials. This highly curated data release revealed some results from the first 275 people enrolled into Regeneron’s large, double-blind trial.

Compared to a low-dose cohort and a placebo control, the press release suggests a high dose of REGN-COV2 resulted in a statistically significant reduction in virus levels. To date, this is the only publicly available data on the efficacy of REGN-COV2 in humans.

Importantly, this aspect of the REGN-COV2 trial focused on patients with early-stage COVID-19, and not severe cases who have been hospitalized. In September, Oxford University announced it would begin testing the efficacy of REGN-COV2 on hospitalized patient outcomes.

Is it safe?

Considering only a few hundred people have received this experimental therapy to date the broad safety profile of REGN-COV2 is unknown. A number of different monoclonal antibody therapies have been extensively studied over the past few decades, treating cancer and autoimmune disease, so the principles of the therapy are sound.

Regeneron has also developed a similar antiviral antibody cocktail targeting the Ebola virus. Called REGN-EB3, this therapy is a trio of antibodies with clinical trials finding it can safely increase one’s chances of surviving the disease if administered soon after infection.

Nevertheless, REGN-COV2 is still in relatively early stages of human testing and the average age of the ongoing Regeneron clinical trial is 44 so there is little evidence of how the therapy works in older, or younger, subjects.

Is this a cure for COVID-19?

No. REGN-COV2 is not a cure for COVID-19.

This particular antibody cocktail is a prospective treatment for those infected with the virus that causes COVID-19. If ongoing trials deliver positive results the therapy will most likely be administered to those subjects most at risk of death or severe illness, ideally as soon as a viral infected has been detected.

Will everyone be able to get this treatment?

Probably not. Monoclonal antibody treatments are expensive to produce and can only be administered in hospital intravenously. Manufacturing millions of doses in a short period of time is unlikely, and prior monoclonal antibody treatments have displayed challenging adverse side effects.

The reality of REGN-COV2 is that it may offer doctors an incredibly valuable new tool in their treatment arsenal, primarily reducing the severity of disease in patients most at risk and hopefully preventing those at-risk patients from ending up in hospital. Not everyone will be able to get this treatment, but not everyone will need this treatment.

What do the experts say?

“So far, several hundred patients with relatively mild disease have been given the drug in so-called phase 2 studies,” says Martin Laundry, from the University of Oxford. “These have shown that the drug is effective in reducing viral load. But they have been too small to know whether they improve patient outcomes such as reducing the duration of hospital stay, reducing the need for mechanical ventilation, or improving survival. Regardless of how one man with this disease fares, we need evidence from the trials before reaching firm conclusions about this treatment.”

“The antibody treatment given to President Trump is an unknown quantity and impossible to assess as I am not aware of any published evidence on what the treatment contains or results from administration to patients,” says Norman Saunders, from the University of Melbourne. “As with any antibody treatment it will carry the risk of an allergic reaction.”

"The Regeneron antibody cocktail containing two monoclonal antibodies designed to block the virus has shown promising early data that suggests it can reduce the viral load and time to alleviate symptoms, however it is still considered investigational hence use should remain in the context of clinical trials," says Paul Griffin, from the University of Queensland. "The difficulty in combining therapies and using experimental intervention outside of a properly conducted clinical trial is that whatever the outcome it will be challenging to know which, if any of these interventions, actually contributed favorably or otherwise."

9 comments
Craig
I believe I heard that expected cost per patient will be a couple hundred thousand bucks, so definitely reserved for high risk patients that are not near end of life.
buzzclick
Looks like the POTUS gets the best treatment available, but I would have thought that President Donald would have stayed at the health center a little longer to maximize the sympathy card. I found it quite funny to see the media, who's been trashing him repeatedly, coming out in wishing him well, but soon after he walked out claiming to be cured, they promptly began to dump him again. lol

paul314
With something that just reduces viral load while it's in the body, the really big question is whether it changes the ultimate course of the disease or just delays it. Unless the patient's immune system does the right thing, exponential growth is still exponential growth. (And of course with COVID-19, if the patient's immune system does too much of the right thing, the patient dies from the resulting inflammation.)
Ferdi Louw
The other option he mentioned was https://investor.lilly.com/news-releases/news-release-details/lilly-announces-proof-concept-data-neutralizing-antibody-ly
usugo
Bummer! I bought a truckload of HCQ for nothing! LOL

Worth noting, the 8g of antibody injection he got has a market value of about $150k (at current Humira price)
Nobody
President Trump had the courage to try it and his rapid recovery may well result in a better treatment for everyone. I am also interested if his routinely taking chloroquine helped with his quick recovery. My own medical doctor is a big advocate of chloroquine and gave me a report that official trials using it were intentionally sabotaged by waiting to use it until the virus was too advanced to really help and that one other trial proving it ineffective was totally falsified and never even took place. He also advised that everyone should take vitamins C, D3, and zinc daily to possibly prevent or reduce the effects of a Covid-19 infection. In the past month I have had eight friends in their 60s get the virus and were tested positive. I told them about my doctor's advise to take the vitamins which most of them did. None of them got very sick and mostly complained of fatigue but recovered quickly. I've often wondered how many of the Covid-19 deaths in the news were part of the yearly 250,000 deaths from medical mistakes ( see Johns Hopkins report).
beaker
It binds to the spike proteins and neutralises the virus, so if that's not a cure then I don't know what is. I'm not sure where people are getting 100,000's of dollars per dose. They are scaling this in 2 factories and last I heard already have well over 100,000 doses. The media are such naysayers and doomers, it's getting old. Not to mention politicising a virus and potential treatments is utter madness. "The treatment is legitimate and curing everyone that gets it, but..... trump likes it so.... there is no evidence or reason to consider this... yadda yadda. yawn.
Aross
Given the amount of "fake news" coming out of the White House I wonder whether Donald Trump actually had Covid-19.
michael_dowling
Antibody therapy probably works by giving the host time to manufacture it's own antibodies in sufficient quantities to knock down the virus before it develops into lethal pulmonary symptoms. Trump must have a robust immune system,in spite of his Big Mac diet.