Why do pharma stay clear of infection control ?Lessons and a warning from #MSCOVID19

W

You want a treatment against EBV and we desperately need new anti-biotics, but as soon as we can make one, the bacteria or virus can mutate to get resistance so that the drug becomes useless. This is true for SARS-CoV-2 and COVID-19. and is happening now

We are feeling better because we have vaccines and anti-virals. These antivirals offer some comfort for vulnerable people should they catch SARS-CoV-2. So you have a few chemicals and you had a few antibodies. Initially you had a cocktail of antibodies (Casirivimab/imdevimab) also known as REGEN-COV and used on President Trump. In the UK you also got Tixagevimab/cilgavimab also know as Evusheld that was fighting alpha-delta variants and this offered an option to people not making an antibody responses. It cost pharma alot to develop these agents and no sooner had they got some form of approval along came omicron and these antibodies were not good enough Casirivimab/imdevimab and Bamlanivimab/etesevimab just didn’t work and are now no longer approved in the US. In the UK you would be tested and if you where omicron positive you wouldn’t be offered Casirivimab/imdevimab. The manufacturers of Sotrovimab were probably happy as this antibody could inhibit alpha and delta but also omicron. So the investment to generate this antibody may have been seen to be good. However, before you can say “flush” Sotrovimab and Tixagevimab/cilgavimab (which had a small effect on omicron) are gone in an instant and the rewards for making the investment to make the antibodies are gone. So if you get COVID-19 and have risk factors for a bad time, I am sorry it to say it looks like your options to get treatment is getting smaller. Why?

Because the Son/Daughter of Omicron does not respond to these antibodies.

There are three now main variants of omicron (BA.1) and BA.2 and BA.3. It seems that BA.2 is on the rise as is thought to be more transmissible than omicron. The impact on therapeutics is now out and it is not good news as the antibodies don’t work against BA.2. This has been found in loads of countries including the US and no doubt will be donated to the World during half-term school holidays:-(. However at the moment BA.1 is dominant in UK in England about 96% of cases were BA.1 about 4.5% was BA.2 and about 0.5% others but apparently in Denmark BA.2 is 65% of cases, less 1% other and the rest BA.2

Monoclonal antibody therapy for the treatment of SARS-CoV-2 infection has been highly successful in decreasing disease severity; however, the recent emergence of the heavily mutated Omicron variant has posed a challenge to this treatment strategy. The Omicron variant BA.1 has been found to evade neutralization by the Regeneron andCasirivimab/imdevimab, sold under the brand name REGEN-COV among others therapeutic monoclonal antibodies, while Sotrovimab and the Evusheld monoclonal antibody cocktail retain significant neutralizing activity. (Not sure I agree about Evsheld which is the Astrazeneca antibody based on other peoples data). A newly emerged variant, Omicron BA.2, containing the BA.1 mutations plus an additional 6 mutations and 3 deletions, 3 of which lie in the receptor binding domain, has been found to be spreading with increased transmissibility. We report here, using a spike protein-pseudotyped lentivirus assay, that Omicron BA.2 is not neutralized with detectable titer by any of the therapeutic monoclonal antibodies, including Sotrovimab and the Evusheld monoclonal antibodies. The results demonstrate the difficulty of identifying broadly neutralizing monoclonal antibodies against SARS-CoV-2 and the importance of the T cell response from which immunoevasion is more difficult.

COI: Non relevant

Disclaimer This is the view of the authors and no institution and it not medical advice,

About the author

MouseDoctor

9 comments

  • I am now a little confused so if you catch covid and do your priority PCR test how do you know which antiviral will work on you?

    nirmatrelvir and ritonavir (Paxlovid)
    sotrovimab (Xevudy)
    remdesivir (Veklury)
    molnupiravir (Lagevrio)

    Why has this not been in the news? I hold out very little hope that the people prescribing the antivirals will have a clue about what you have said

    • At the moment the is no reason to think that remdesisivr and molnpupiravar won’t work and paxlovid will work it is just whether it affects your DMT to make it stronger. I doubt there is much impact for any, but at the moment only siponimod and cladribine have been flagged. Sotrovimab would work as long as you do not catch B1.2. This risk in UK is currently low because B1.2 only makes up 4-5% of cases but it will be on the increase. The only way to know if you have B1.2 is to sequence the variant. It can only be detected by sequencing as the B1.2 lacks the PCR hole present in alpha and B1.1. I suspect this means that sotrovimab will be removed from the table as it will be easier to give a chemical antiviral.

      Why have you not heard this, the paper was only launched last night…you get the news here as it arrives:-)….Remember in UK B1.2 is only a low percentage of cases.

      • I know I get my news here which is fantastic what I meant was everything seems to be kept quiet now and I bet this news may not filter through as figures etc are not even being reported at night now on the news giving the impression that everything is back to normal.
        The government’s plan is quite obviously to keep as much info back as possible hence why I have people saying to me it’s fine for you now look people are not wearing masks anymore the the Threat must be diminishing.

        I get my news from yourselves, independent sage and Medics like Professor Christina pagel who explain what is going on on and how best to protect yourself.

        • There are still 40,000 people infected a day (in the UK) the vaccine give limited protection against getting infected (severe disease is probably different) and even 4 doses of vaccine, in the absence of immunosuppression, can exhibits poor (20-30%) protection from omicron infection based on one publication. But luckily breakthrough infections were commonly, very mild (Regev-Yochay et al. Medrxiv doi: https://doi.org/10.1101/2022.02.15.22270948) and severe disease is limited by the extra vaccination (Yinon et al. MedRXiv doi: https://doi.org/10.1101/2022.02.01.22270232). This paper is more optimistic than the former paper and argues differently but the n is small ..It seems high levels of antibody are required to protect against infection.

  • 20-30% protection even if not immunosuppressed? And with four vaccinations? That is really scary.
    We’re being told that the vaccinations are very effective against omicron!
    There is no plan to offer a 4th
    vaccinations in the UK so are you not worried?
    I hope I have completely misread what you said!
    Also you imply that the more antibodies you have regularly the better it is so for someone like myself who is 3 times vaccinated but living the life of a hermit is in real danger and it would be better to expose myself to the virus which as it is milder at least would give me antibodies is that correct?
    Prof g recently posted an MS selfie implying that everything is really quite safe now if we are sensible which contradicts this. He said that vaccinations, antivirals and careful living everyone should be ok really with a current variant

    • I think the protection is higher shortly after vaccination. I put two papers the other is much more upbeat but I think with three dosese the protection only lasts so long. The levels have to be high to stop it and one suspects you need another vaccine specific for omicron would be a good idea. I also think the vaccines are effective against omicron because most people who do get symptomatic infection have mild disease.

      There is no plan for 4th unless you have been immunosuppressed many people in UK have already had 4 jabs including a few people I know…it is abit frustrating as they have a much better antibody response than me.

      Protection against symmptomatic infection depends on the level of antibody. T cell action starts to kick in after infection, however there will be a threshold level that once you achieve this you will be protected….once the levels drop you have risk of infection. I do not think it is better to get yourself infected butthere is a reasonable chance of this happening in the future…I guess it will get to stage where we dont test and you will never know but happy that omicron is less lethal.

      “Everything is quite safe if we are sensible”….If you travel into London it is clearly evident that people aren’t that sensible and most people have had enough and dont care. However at some point you have to get back on the horse…you can’t be a hermit forever….but there are vaccinations and anti-virals and you only have to look at the death rate and you can see the benefits and remember many of those adding to the bad figures are not vaccinated.

  • Guess it’s back to waiting for swissmedic to approve paxlovid for me then. Any decade now. 😒

    These clowns never actually managed to approve evusheld while it would have been useful.

    • Paxlovid inhibition of hosptiallization by 90%…..I would take that option if I could, when I get COVID….but its not going to be an option I will just have to go with one of the alternatives. Evusheld went with the others when omicron arrive…it has not been a good pandemic for AZ:-(

By MouseDoctor

Translate

Categories

Recent Posts

Recent Comments

Archives