Monoclonal antibodies, the experimental cure given to Trump

Without heating yet, monoclonal antibodies come into play. Freshly administered to the President of the United States, Donald Trump, these experimental drugs against Covid are a real promise for many. However, they are still too young to have played important matches. They are in phase three of the tests: infused into a few hundred volunteers, positive but without the need for hospitalization, and not even the US Food and Drug Administration has heard in such a preliminary phase authorize them with an emergency procedure to the population. general. Better to wait for the final results, it was decided. Despite this, today the monoclonal antibodies of the American company Regeneron were administered via drip to Patient One: the president of the United States. And in the maximum dose allowed by experiments – 8 grams. A true baptism of fire.

Monoclonal antibodies are antibodies made in the laboratory from the natural antibodies of patients recovered from Covid. They are indicated, at least as the experiments suggest, for those patients with weak immune systems that cannot activate their own antibodies against the coronavirus. Selecting the best antibodies in the plasma of cured patients is not easy: some are much more powerful than others, when it comes to blocking the coronavirus that tries to penetrate our cells to replicate. They work by binding to the microorganism, preventing it from entering our cells and allowing other actors of the immune system to eliminate it. However, in the face of a new virus, antibodies need time (7-10 days) to form, organize and act. In Covid, some patients find it much more difficult than others to produce them, and this is one of the reasons why the symptoms are sometimes very severe. Once the choice of the most promising natural antibodies has been made in the laboratory, the production of the artificial copies begins. Regeneron, who had developed a similar method against Ebola in the past, uses a cocktail of two different antibodies: two “policemen” may be able to better handcuff the virus. Other labs (like Toscana Life Sciences in Siena) use three in combination. In the work of this therapy, in Italy, there is also the University of Rome Tor Vergata, in collaboration with Spallanzani.

The Italian groups promise to complete the tests in spring. The American companies Regeneron and Eli Lilly, meanwhile, have already given the next stages of the trials, with promising results. Trump’s Regeneron cocktail had previously been administered to 275 patients. It has been shown to significantly reduce the amount of the virus, at least at the maximum dose of 8 grams, and it poses no health risks, but only in a company press release, with the data not yet published in a scientific journal. The lower dose, on the other hand, did not give significant results.

The bottleneck, if these drugs are approved, will be cost. In fact, producing them is neither trivial nor quick. One dose should cost several thousand euros. It certainly won’t be a massive cure: monoclonal antibodies could be reserved for the seriously ill. In addition to therapy, they could also serve as prophylaxis for highly exposed people, especially in hospitals. One such trial is underway in Great Britain with Regeneron’s drug. They are effective immediately, the moment they are administered. But they don’t last long. Unlike the vaccine, its effect wears off after a few weeks.

Trump also receives remdesivir, an antiviral produced by American Gilead that has shown some signs of efficacy against Covid. The United States, in July, had bought all the inventories produced between there and the end of September, leaving only the minimum for the rest of the world. There is no news that the president is receiving chloroquine. The other medications listed in the White House medical document are either over-the-counter or are considered ineffective.