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Trump has come to proclaim a free cure. He stands in front of the Oval Office on the White House lawn, the shadows of the trees fluttering above his head. He speaks to the camera for about four minutes and reports how he suddenly felt better after being treated with a certain drug. All Americans should be treated the same as him, says Trump. Free.
For this reason, he will ensure that this and another drug are approved quickly. “They call it therapeutic,” says Trump. “For me it was much more than that. It was a cure.” The President of the United States repeatedly addresses people who are in the hospital with Covid-19.
In fact, two companies, Regeneron and Eli Lilly, applied for emergency approval of anti-Sars-CoV-2 antibody drugs in the US on Wednesday. Trump received one of the funds at the beginning of his illness. Experts rate both drugs as promising. However, it has not yet been shown that they can actually help seriously ill patients. The most important facts:
How do antibody therapies work?
In therapies, patients are given artificially generated antibodies that are supposed to bind to the coronavirus and prevent it from entering cells. The virus can only multiply there. For this reason, antibody therapies are linked to two different hopes:
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They are designed to protect infected people from serious diseases.
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However, they can also protect healthy people from infection, and therefore can be used by doctors and nurses until suitable vaccines are available.
Studies are currently being conducted for both agents which have now been discussed to investigate a protective effect in healthy people. The results are still pending. On the other hand, there are initial data on the effect of the agents on infected people.
What is known about the effect of the remedies?
The first remedy is the cocktail of antibodies that Trump received shortly after his diagnosis. It is manufactured by the American biotech company. Regeneron. The cocktail contains two antibodies that are directed against a key Sars-CoV-2 protein.
Currently, the company is still working on studies that will collect data on the drug’s effects and side effects. Based on initial interim results, the agent can reduce the amount of virus in infected people and shorten the duration of symptoms. Study participants whose immune systems had not yet produced their own antibodies to the virus benefited particularly strongly.
Whether the drug helped Trump or not cannot be said. In addition to the antibody cocktail, the president of the United States also received two drugs that are used primarily for seriously ill patients. In principle, conclusions about the effect of a drug should only be drawn from individual patient reports in absolutely exceptional cases. Instead, new drugs are typically tested on hundreds or even thousands of people.
The second, very similar remedy comes from the pharmaceutical company. Lilly. Although the company is also investigating a cocktail of two antibodies, emergency approval has only been submitted for one of the two antibodies. The request for the cocktail is scheduled for November, when more data is available. Therapy with more than one antibody is likely to reduce the risk of resistance.
So far, Lilly has only released the interim results of an ongoing study. Consequently, the antibody can also reduce viral load in patients. Also, according to the company, fewer patients had to go to the hospital or emergency room compared to a placebo group. However, due to the small number of affected subjects, this statement should be viewed with caution.
The results known so far for both antibody therapies also have a major limitation: they are based exclusively on data from patients who only had mild to moderate symptoms and at the time of therapy. Not he had to be treated in the hospital. Studies are currently being conducted in seriously ill clinical patients, but the results are still pending.
It is also important to know that the results published so far are only based on data from a few hundred patients. The results have not yet been published in specialized journals nor have they been reviewed by independent experts. However, as studies continue, new results can be expected soon. After all, none of the companies have reported any serious side effects so far.
What do independent experts think of the therapies?
The drugs are very promising, says Martin Landray of the University of Oxford. “Both studies show that monoclonal antibodies that target the coronavirus spike protein can lower viral load and improve symptoms.” However, to assess whether agents can effectively prevent severe courses, much more data is required.
“We need to know if the funds can really improve patient outcome, that is, avoid hospital admissions, shorten hospital stays, reduce the amount of artificial respiration and improve the chances of survival,” says Landray. Also, information is needed on how well medications are working, for example for the elderly, different ethnic groups, or people with other diseases.
Stephen Evans of the London School of Hygiene and Tropical Medicine sees the situation in a similar way. The evidence for the effectiveness of antibodies is encouraging but still limited. “The fact that an emergency license has been applied for in the United States does not mean that companies already have enough data together, but they hope to have it very soon.”
Trump promises free treatment for all Americans. Are there enough medications?
Antibody production is complex and expensive, and their quantities are limited. However, both companies have already started production regardless of the results of their studies.
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“Currently, the doses are available for approximately 50,000 patients,” Regeneron writes in a statement. “However, we expect the doses to be available for a total of 300,000 patients in the coming months.”
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Lilly guarantees a million doses of her antibody in the fourth trimester, albeit in the lowest of the doses tested.
For comparison: in the past seven days alone, according to authorities, more than 300,000 people have been infected with Sars-CoV-2 in the US.
Bottom Line: Antibody treatments could become an important component of Covid 19 therapy. However, it is not yet clear how much patients benefit from the funds. Studies are currently underway on this issue. Antibodies are unlikely to be a “cure,” but at best they can protect people from serious infections and diseases.
