COVID Breakfast….Whilst Clapping for the NHS

C

Well I don’t want you to choke on your breakfast, so I have posted whilst you have your supper but there is some good news and this is that the City-Boys are making a killing out of COVID-19.

I have been watching the share price of Gillead. This company makes an anti-viral drug called remdesivir. This was developed to treat Ebola virus. A couple of days ago, it took a drop with the news published in the Lancet that it failed in COVID-19, it did not reduce the time of recovery of death.

Wang et al. Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial. April 29, 2020DOI:https://doi.org/10.1016/S0140-6736(20)31022-9

The share price dropped on the 28th of April a day before it published..Em.

So were the animal studies all crap. After all were were told when then when you test anti-virals in cell culture only one shone through.

Evaluation of 19 antiviral drugs against SARS-CoV-2 InfectionShufeng Liu, Christopher Lien, Prabhuanand Selveraj, Tony WangbioRxiv 2020.04.29.067983; doi: https://doi.org/10.1101/2020.04.29.067983

Here we report that after screening 19 antiviral drugs that are either in clinical trials or with proposed activity against SARS-CoV-2, remdesivir was the most effective. Chloroquine only effectively protected virus-induced cytopathic effect at around 30 micromolar with a therapeutic index of 1.5. Our findings also show that velpatasvir, ledipasvir, litonavir, lopinavir, favilavir, sofosbuvir do not have direct antiviral effect.

Then there are the monkeys

Clinical benefit of remdesivir in rhesus macaques infected with SARS-CoV-2 Brandi N et al. bioRxiv 2020.04.15.043166; doi: https://doi.org/10.1101/2020.04.15.043166

However, the monkeys were infected 12 hours after infection and it reduced viral load. However in the Chinese trial people could start drug up to 12 days after symptom onset, so probably about 2.5-3 weeks after infection so you have two hopes of it working…… one is Bob Hope and the other is probably No hope. We have seen this in trials in progressive MS, you start very late and drugs don’t work. Now I have to say also the Chinese study was stopped early because they couldn’t recruit enough people as the the epidemic was waning.

However, why the the Jump in the Gillead Share price on 29th of April, well on 29th of April

Wednesday, April 29, 2020

NIH clinical trial shows Remdesivir accelerates recovery from advanced COVID-19.

An independent data and safety monitoring board (DSMB) overseeing the trial met on April 27 to review data and shared their interim analysis with the study team. Based upon their review of the data, they noted that remdesivir was better than placebo from the perspective of the primary endpoint, time to recovery, a metric often used in influenza trials. Recovery in this study was defined as being well enough for hospital discharge or returning to normal activity level.   

Preliminary results indicate that patients who received remdesivir had a 31% faster time to recovery than those who received placebo (p<0.001). Specifically, the median time to recovery was 11 days for patients treated with remdesivir compared with 15 days for those who received placebo. Results also suggested a survival benefit, with a mortality rate of 8.0% for the group receiving remdesivir versus 11.6% for the placebo group (p=0.059).

The trial has shown positive data. Now If you have been watching the COVID literature, this information was leaked by a webinar getting onto the web a few days ago.

Therefore, this is good news for city-boys as the share prices jumped and hopefully all of us. So the question is can enough of this drug be made? This is early days but it is in the right direction, but it is not a cure. But I predict that if people get this agent after symptom onset rather than after hospitalization then things will be even better.

Bollocks, I should have bought some shares……would it been insider dealing?

Also in another study looking at people with autoimmune issues taking drugs there has been

Haber et al. Covid-19 in Immune-Mediated Inflammatory Diseases — Case Series from New York

We identified 86 patients with immune-mediated inflammatory disease who had either confirmed (59 patients) or highly suspected (27 patients) symptomatic Covid-19 infection (Table 1, and Table S1 in the Supplementary Appendix, available with the full text of this letter at NEJM.org). Of these patients, 62 of 86 (72%) were receiving biologics or Janus kinase (JAK) inhibitors, and the overall incidence of hospitalization was 16% (14 of 86 patients). The hospitalized patients were older than the ambulatory patients. Although the distribution of diagnoses of immune-mediated inflammatory diseases was similar in the ambulatory group and the hospitalized group, a higher percentage of admitted patients had rheumatoid arthritis. As compared with the ambulatory patients, more of the patients for whom hospitalization was warranted had coexisting hypertension, diabetes, or chronic obstructive pulmonary disease.

Therefore this goes in the same direction as the italian data for MS

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MouseDoctor

3 comments

  • Don’t know about the insider dealing thing. I bought about 125 shares of Gilead when the Covid thing began heating up. I had seen the Remdesivir part and read up on its history, and thought, well, maybe..

    So it’s gone up and down a bit since, mostly up, a little, so I’m 1-2K ahead depending on the day and the mood of the market. You have to put a lot in to get a lot out. Do you really want to tie up or risk a lot of money if you are not sure of the reward? But it pays a good, predictable dividend, so you make money anyway, even if the Remdesivir doesn’t work out and you can afford not to sell the stock fo a while. In the US, the Remdesivir story hit the headlines Wed and is being received very well. I don’t think a lot of people realize it’s an IV treatment and not a pill, given only in the hospital. In the US, in some states you can have your IV steroids at home. That would be excellent with Remdesivir, early on.

    • Insider dealing you know me…just want to stirr up a bit of SH1. Thanks I did not realise it is an infusion, so in reality this will make it a treatment of hospitalisation and therefore not really useful. The famivir surfaced on pubmed yesterday as another option.

      • It’s talked about here as a big deal, on the regular news as well as right wing news and yesterday the King (pres), had Gilead pres come in to oval office, and hammed it up with him. But it does sound quite helpful, but far from a cure. It’s a real treatment.

        I’m thinking, in my novice way, that testing becomes very easy. Say all restrictions are lifted but everyone is told to be very careful, and sick & elderly & very high risk people still hide at home. ANY sign of any infection is quickly tested for anyone. If you have it, you proceed on a predetermined route according to your age and risk factors. For many people that would include at-home IV Remdesivir treatment immediately. Maybe a 50% reduction in serious cases and deaths without hospitalization? Just a novice guess. That would be enough to give me confidence (62 yrs, moderately good health) to go out and get back to my routine, if things were open.

        Thanks to all again for all the fascinating and good info.

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