Editor’s Note: This page is updated weekly with new information related to COVID-19 testing and potential treatments in development. Click the arrow next to the date to expand the text.
Pfizer and BioNTech announced positive early data from their joint Phase 1/2 clinical trial testing BNT162b1, one of four COVID-19 vaccine candidates in their BNT162 mRNA-based vaccine program. Out of three dosages, all 24 participants who received the low (10 mcg) or medium (30 mcg) dose of the vaccine produced roughly two to three times more neutralizing antibodies than those seen in recovered COVID-19 patients, Adverse reactions were generally mild to moderate, and no serious adverse events were reported. The companies expect to select a lead candidate from the four experimental vaccines to advance into a Phase 2b/3 trial, which may launch later this month.
Japanese pharmaceutical company Fujifilm has announced a deal with India’s Dr. Reddy’s Laboratories and Dubai-based Global Response Aid for the development, manufacture, and sale of its anti-flu medication Avigan (favipiravir) as a possible COVID-19 treatment. Under the terms of the agreement, Dr. Reddy’s and Global Response Aid will have exclusive rights to the medication outside Japan, excluding Russia and China. Fujifilm will provide the two companies with data it has collected from its studies, which they will use to conduct clinical trials in countries where the infection is spreading. Trials in Japan and the U.S. are currently evaluating Avigan’s potential as a COVID-19 treatment, while India and Russia have already approved it for that use. Avigan has been approved in Japan as an influenza treatment since 2014.
The U.S. Food and Drug Administration issued emergency use authorization for Centogene’s new test kit for the detection of SARS-CoV-2, the virus that causes COVID-19. The test uses the well-established polymerase chain reaction technique to detect the virus in upper respiratory tract samples taken by oropharyngeal swab. The samples are collected from individuals who have been exposed to or are suspected to have the virus, and analyzed by qualified lab personnel in a Centogene laboratory.
EUSA Pharma has received FDA approval to launch a Phase 3 trial to evaluate the safety and efficacy of Sylvant (siltuximab) in hospitalized COVID-19 patients with acute respiratory distress syndrome. Sylvant is an antibody that blocks interleukin-6, a cell signaling molecule that can trigger inflammation. The trial expects to enroll approximately 400 patients who will be randomly assigned to receive either Sylvant or a placebo in addition to standard care. The primary measures will be improvements in lung function, length of hospital stays, and all-cause mortality. Sylvant is approved for the treatment of Castleman disease, a rare condition of the lymph nodes and related tissues.
The FDA granted Biophytis an investigational new drug clearance for a Phase 2/3 trial testing Sarconeos (BIO101), an experimental oral medicine for the treatment of acute respiratory failure associated with COVID-19. The first part of the trial will assess the medicine’s safety and efficacy in 50 hospitalized COVID-19 patients experiencing acute respiratory deficiency. The second part will evaluate the efficacy of Sarconeos on respiratory function in an additional 300 patients. Biophytis has been developing Sarconeos for the treatment of sarcopenia (muscle loss due to aging), and Duchenne muscular dystrophy.
Regeneron announced the start of a Phase 3 trial to study whether an antibody cocktail dubbed REGEN-COV2 can prevent COVID-19 infections among those who have been exposed to the virus. The trial is being conducted in collaboration with the National Institute of Allergy and infectious Diseases. Following a positive Phase 1 safety review from an independent monitoring committee, the company is also advancing the therapy into two Phase 2/3 trials in hospitalized and ambulatory COVID-19 patients. Under the Operation Warp Speed program, the U.S. government recently signed a $450 million deal with Regeneron for the manufacturing of REGEN-COV2 upon successful completion of clinical trials.
The U.S. government signed a similar deal with Novavax, providing the Maryland-based pharmaceutical company $1.6 billion to manufacture up to 100 million doses of its experimental vaccine, NVX‑CoV2373. The doses owned by the government would become available for use in clinical trials or for distribution in the event of FDA emergency use authorization or approval of the vaccine. Novavax is currently testing NVX‑CoV2373 in 130 healthy volunteers in Australia in a Phase 1 trial (NCT04368988). The company expects early safety and immune response results this month.
The World Health Organization is halting the testing of hydroxychloroquine and Kaletra (lopinavir/ritonavir) in hospitalized COVID-19 patients in its multinational Solidarity trial after determining that these medications had little to no effect on mortality rates. Furthermore, the organization identified several adverse events associated with these compounds, which it will review. This decision does not extend to the possible study of these treatments in non-hospitalized patients or as a preventive measure before or after exposure to SARS-CoV-2.
Gilead has set its price for the experimental antiviral remdesivir at $390 per vial. A five-day treatment course of six vials of the therapy, which is based on current treatment patterns, will equate to $2,340 per patient, Gilead CEO Daniel O’Day said in an open letter. In the U.S., however, the price of the treatment for private insurance companies will be $520 per vial, because of the unique characteristics of the U.S. system and the discounts that government healthcare programs expect. According to O’Day, this price will remove the need for country-by-country price negotiations. Gilead has entered into agreements with generic drugmakers to deliver treatment at a lower cost in the developing world. Remdesivir has shown promise in clinical trials against COVID-19.
FibroGen has begun a Phase 2 trial of pamrevlumab for the treatment of hospitalized COVID-19 patients. Pamrevlumab is an investigational monoclonal antibody that is also being tested for the treatment of idiopathic pulmonary fibrosis, locally advanced unresectable pancreatic cancer, and Duchenne muscular dystrophy. The randomized trial (NCT04432298), which is actively recruiting participants in the U.S., will assess pamrevlumab’s safety and efficacy in up to 130 patients with acute COVID-19, compared with a placebo. More information on enrollment can be found here.
The U.S. Food and Drug Administration approved the launch of Fulcrum Therapeutics’ Phase 3 trial of its investigational anti-inflammatory medication losmapimod for the treatment of hospitalized COVID-19 patients. The international, randomized trial, called LOSVID, will enroll an estimated 400 COVID-19 patients at risk of progressing to critical illness based on older age and elevated systemic inflammation. Participants will be randomized to either 15 mg twice per day of losmapimod or a placebo, in addition to standard care, for 14 days. The trial’s primary measure is the proportion of patients who progress to death or respiratory failure by day 28. Top-line data from the trial is expected in early 2021.
Catalent and Moderna have signed an agreement to fill and package 100 million doses of Moderna’s mRNA vaccine candidate — known as mRNA-1273 — with potential to produce hundreds of millions more. The companies hope to be able to begin distributing doses in the U.S. later this year. Catalent has inked similar agreements with Johnson & Johnson and AstraZeneca.
Vaxart’s COVID-19 vaccine candidate was selected to participate in a primate study funded by the U.S. government’s Operation Warp Speed, the company announced. Vaxart is developing this vaccine, and others in its pipeline, as oral tablets, rather than as an injectable liquid solution. “Vaxart believes that a room temperature stable tablet vaccine is easier to distribute, store and administer than injectable vaccines and may provide significantly faster response to a pandemic than injectable vaccines,” the company stated in a press release.
The U.S. Army Medical Research and Development Command awarded $4.7 million to Altimmune to fund a Phase 1/2 trial (NCT04442230) of T-COVID, an investigational COVID-19 outpatient treatment. T-COVID is an intranasal (administered via the nose) immune modulator, designed to prevent patients from progressing to a severe disease condition. Altimmune expects to begin recruiting participants for the trial in the coming weeks and to produce trial data by the end of the year.
The World Health Organization unveiled plans to secure 2 billion doses of a future COVID-19 vaccine by the end of 2021. The plan calls for countries to pool their resources to invest in a broad selection of experimental vaccines, thereby spreading the risk of betting on any particular candidate. The WHO estimates it will need $31.3 billion in funding over the next 12 months to execute its plan. To date, $3.4 billion has been secured from contributing countries.
Imperial College London dosed the first participant in a Phase 1 trial of its COVID-19 vaccine candidate. Researchers initially plan to recruit 15 healthy volunteers, in whom they will test the safety of increasing doses of the potential vaccine. After this, the goal is to scale up the trial to 300 participants, with larger trials being planned for later in the year. The trial is actively recruiting; more information can be found here.
Inovio recently announced positive results for its COVID-19 vaccine candidate, INO-4800. According to the company, 94% of the 36 healthy volunteers treated with the potential vaccine in a Phase 1 trial demonstrated an immunological response, but it provided few other supporting details. INO-4800 has also been selected for preclinical primate studies under the Operation Warp Speed program. The company is anticipating the launch of a Phase 2/3 efficacy trial sometime this summer.
The U.S. Department of Health and Human Services recently released a fact sheet explaining the Operation Warp Speed program announced in mid-May. Pharmaceutical companies selected for the program, which is a public-private partnership aimed at stimulating COVID-19 vaccine, therapeutic, and diagnostic development, will gain priority access to manufacturing capacity and needed supplies. The goal of Operation Warp Speed is to deliver 300 million doses of a safe and effective vaccine by early next year. Fourteen vaccine candidates have already been identified, of which seven of the most promising will be chosen to advance to early-stage trials. Those candidates that are successful in early studies will then go on to testing in large-scale trials.
At the same time, the European Union has launched its own strategy to coordinate vaccine development for COVID-19, with the goal of having safe and effective vaccines available within 12 to 18 months. The European Commission will devote a significant portion of a roughly $3 billion emergency fund to advance purchases of potential COVID-19 vaccines from companies, with additional support made available through European Investment Bank loans. The commission has further proposed a global effort wherein high-income countries would support low- and middle-income countries in reserving vaccines, so that countries of all income levels have access to life-saving measures, when they become available.
The U.K. Medicines and Healthcare Products Regulatory Authority suspended recruitment for clinical trials of hydroxychloroquine as a potential treatment for COVID-19. The decision follows data from two trials, including the large-scale RECOVERY trial (NCT04381936), that found that the medication provides no meaningful benefit to hospitalized COVID-19 patients. The agency advises those taking hydroxychloroquine and chloroquine for other conditions to continue to do so, as advised by their physician.
Similarly, the World Health Organization has suspended the hydroxychloroquine arm of its global Solidarity trial, which is seeking effective treatments for COVID-19 patients. The WHO’s decision was based on results found in the Solidarity trial, as well as those of the RECOVERY trial and other reviewed evidence. According to the organization, its decision does not apply to the use of hydroxychloroquine as a preventive treatment among those who have been exposed to the virus.
Following positive results in another arm of the RECOVERY trial, the U.K. has authorized the National Health Service to treat COVID-19 with dexamethasone. Trial findings announced last week showed that the medicine reduced the risk of death among patients requiring both ventilation and oxygen-only therapies. The government has already taken steps to secure supplies of the medicine and currently has enough to treat more than 200,000 people.
Gilead Sciences will soon begin enrollment for an open-label Phase 2/3 trial (NCT04431453) testing the antiviral medication remdesivir among hospitalized children with COVID-19. The trial will assess remdesivir’s safety, tolerability, pharmacokinetics (movement in the body), and efficacy among approximately 50 patients, from newborns to adolescents, with mild to severe COVID-19. This trial will take place at more than 30 sites across the U.S. and Europe. Gilead has been providing remdesivir for children with severe COVID-19 under compassionate use since February.
Clover Biopharmaceuticals has begun a randomized Phase 1 trial (NCT04405908) of its COVID-19 vaccine candidate, SCB-2019, in Australia. The trial, which is enrolling an estimated 150 patients, will test SCB-2019 alongside adjuvant (assisting) medications from GlaxoSmithKline and Dynavax. The first patient was recently dosed, and the company expects preliminary results in August.
Sanofi intends to begin a Phase 1/2 trial of its COVID-19 vaccine candidate in September. If all goes well, the company anticipates full approval in early 2021. This timeline accelerates that which the company had earlier proposed, when it agreed to develop the vaccine with GlaxoSmithKline. Sanofi is also planning to start a Phase 1 trial by the end of the year testing an mRNA vaccine candidate developed in conjunction with Translate Bio. Pending positive results, it is aiming for approval in the latter half of 2021.
Glenmark Pharmaceuticals received approval for emergency use in India of its influenza antiviral favipiravir for treating mild to moderate COVID-19. This marks the first medication authorized for treating COVID-19 in the country. The company intends to market the therapy under the brand name FabiFlu. Glenmark is simultaneously conducting a Phase 3 trial of favipiravir as a COVID-19 monotherapy at nine sites across India.
Dexamethasone has been shown to reduce the risk of death among COVID-19 patients needing supplemental oxygen, according to results from the Phase 2/3 RECOVERY trial (NCT04381936), a U.K. study that is testing a variety of potential therapies to treat the virus. Dexamethasone is a generic steroid often prescribed to treat inflammatory conditions. During the trial, the treatment lowered the risk of death by one-third among patients needing ventilation and by one-fifth in patients receiving oxygen therapy only. It showed no benefit in patients not requiring respiratory support. The researchers are now working to validate and publish the trial results.
The U.S. Food and Drug Administration has now revoked the emergency use authorization for chloroquine phosphate and hydroxychloroquine sulfate for the treatment of COVID-19. Based on available evidence, the agency determined that suggested dosing regimens for the two treatments are unlikely to produce an antiviral effect, that observations of decreased viral shedding attributed to their use have not been consistently replicated, and that recent clinical trial data show no evidence of their benefit in treating COVID-19. According to the FDA letter, known and potential benefits of these treatments do not outweigh their known and potential risks.
Moderna, in collaboration with the U.S. National Institutes of Health, is planning to launch a 30,000-person, placebo-controlled Phase 3 trial of its candidate COVID-19 vaccine in July. The trial’s primary goal is to determine whether the vaccine, known as mRNA-1273, can prevent symptomatic COVID-19. Secondary measures will test the vaccine’s ability to prevent infection or hospitalization. The first group of healthy volunteers have been fully enrolled in the current Phase 2 trial (NCT04405076) testing the vaccine, which was granted fast track designation by the FDA in May.
Researchers at the Universities of Birmingham and Oxford in the U.K. are screening Izana Bioscience‘s namilumab and Celltrion Healthcare’s Remsima (infliximab) for the treatment of COVID-19 as part of the multi-arm, multi-stage CATALYST trial. Namilumab is a human monoclonal antibody already in late-stage clinical trials for the treatment of rheumatoid arthritis, ankylosing spondylitis, and plaque psoriasis. Infliximab is used to treat inflammatory conditions, including eight autoimmune diseases. The goal of the CATALYST trial is to identify existing therapies that have the potential to treat COVID-19 and can be funneled into large Phase 3 trials in hospitalized patients.
The European Medicines Agency has issued a statement advising patients to continue taking their blood pressure and heart medications as directed by their doctors during the pandemic. According to the agency, the use of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers have not shown any negative effects on patients with COVID-19 in numerous studies. The EMA says it will continue to monitor data and will provide ongoing advice on the safety of the medicines in collaboration with other regulators and international organizations.
Regeneron has begun the first Phase 1/2 trials (NCT04425629 and NCT04426695) testing REGN-COV2, an antibody cocktail, for the treatment of COVID-19 in hospitalized and non-hospitalized patients. The clinical program will also include trials that will assess REGN-COV2’s ability to prevent COVID-19 in two other groups: uninfected individuals at high-risk of exposure and uninfected individuals with close exposure to a COVID-19 patient. Phase 1/2 data will be used to guide the protocol for later Phase 3 studies.
AstraZeneca has licensed six potential COVID-19 antibodies from Vanderbilt University and plans to begin testing a combination of two of them within the next two months. The company has signed deals with the Biomedical Advanced Research and Development Authority and the Defense Advanced Research Projects Agency, both U.S. governmental agencies, to help advance this effort.
Eli Lilly began enrolling patients into a Phase 3 trial (NCT04421027) to test its rheumatoid arthritis treatment Olumiant (baricitinib) in hospitalized COVID-19 patients. This trial, which will complement other ongoing trials of baricitinib in COVID-19 patients, will evaluate the proportion of patients treated with 4 mg of Olumiant who die or require ventilation by day 28, compared with those given a placebo. Lilly expects to enroll about 400 patients in the U.S., Germany, Spain, and Mexico.
Preliminary results from a randomized Phase 1/2 trial (NCT04352608) showed that Sinovac’s COVID-19 vaccine candidate CoronaVac induced an immune response among patients. According to the Beijing-based company, more than 90% of participants generated neutralizing antibodies after receiving the vaccine and that no serious adverse events occurred. The company expects to advance the vaccine to a Phase 3 trial “in the near future.”
Gilead Sciences has filed for approval in the European Union for remdesivir to treat COVID-19, according to the European Medicines Agency, which received a conditional marketing authorization application for the treatment. Because some of the data were already submitted under a rolling review, the agency expects to complete its review of the data under a shortened timeline. If the information submitted is deemed sufficient, the agency will work with the European Commission to potentially fast-track approval of the therapy.
Hydroxychloroquine provides no benefit to patients with COVID-19, according to preliminary results of the Phase 2/3 RECOVERY clinical trial (NCT04381936). The randomized study, which enrolled more than 11,000 patients across the U.K. and is testing a variety of therapies to treat the virus, found that the antimalarial showed no beneficial effect on the length of hospital stays nor on other disease outcomes. Based on these results, the investigators made the decision to stop enrolling patients in the hydroxychloroquine arm of the trial.
As the controversy over hydroxychloroquine continues, The Lancet journal recently retracted the article, “Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis.” The study’s results showed there was no benefit to hydroxychloroquine or chloroquine treatment on hospital outcomes for COVID-19, but three of the paper’s authors made the decision to retract based on the fact that they had failed to complete an independent audit of the data underpinning their analysis. Because of this, they wrote in a statement for The Lancet, they “can no longer vouch for the veracity of the primary data sources.”
Brazil’s Ministry of Health approved clinical trials of AstraZeneca and Oxford University’s COVID-19 vaccine candidate, making it the first country outside the U.K. to do so. The vaccine candidate, known as both ChAdOx1 nCoV-19 and AZD1222, is one of the first to move into Phase 2 testing. Reuters has reported that this vaccine will simultaneously enter both Phase 2 and Phase 3 trials to speed its development. The first round of trials, conducted by Federal University of São Paulo and funded by Brazil’s Lemann Foundation, will test the vaccine in 2,000 volunteers who have not previously contracted COVID-19.
Inovio will begin testing its COVID-19 vaccine candidate, INO-4800, in a Phase 1/2 trial in South Korea later this month in collaboration with the International Vaccine Institute and Seoul National University Hospital. The trial will assess the vaccine’s safety, tolerability, and ability to produce an immune response in 40 adults, ages 19 to 50 years. Inovio plans to expand this trial to include an additional 120 people ages 19–64.
Eli Lilly has partnered with Shanghai-based biotech Junshi Biosciences to begin testing a second potential COVID-19 vaccine. Similar to Eli Lilly’s first candidate, known as LY-CoV555, JS016 is also an engineered antibody that showed promise in preclinical studies in neutralizing the SARS-CoV-2 virus, which causes COVID-19. The first healthy volunteer in a randomized Phase 1 trial was recently dosed at Huashan Hospital affiliated with Fudan University in China.
AbbVie has partnered with Harbour BioMed, Utrecht University, and Erasmus Medical Center to develop 47D11, a monoclonal antibody therapy for COVID-19. AbbVie will support its partners through preclinical activities while preparing for later-stage preclinical and clinical development. Under the terms of their agreement, AbbVie will also have the option to exclusively license the antibody for worldwide therapeutic development and commercialization.
Australian biotech CSL, along with the University of Queensland (UQ) and the Coalition for Epidemic Preparedness Innovations (CEPI), have joined forces to accelerate the development of a COVID-19 vaccine candidate first developed by UQ. CSL and CEPI will fund industrial-scale manufacturing of potentially 100 million vaccine doses by the end of 2021, should the product win approval.
Preliminary research shows that AstraZeneca’s blood cancer treatment Calquence (acalabrutinib) provides a benefit to hospitalized COVID-19 patients. Of 19 severe COVID-19 patients treated with Calquence, 11 who had needed supplemental oxygen no longer needed it, and four of eight patients on mechanical ventilation were successfully taken off. The company said the positive results support the launch of a global Phase 2 trial, which was announced in April.
FibroGen has enrolled the first patient in a Phase 2/3 trial in Italy to evaluate pulmonary fibrosis treatment pamrevlumab for severe COVID-19. The trial will assess the effect of pamrevlumab on blood oxygenation in 68 hospitalized patients who will receive either pamrevlumab or standard care. The company also is planning two Phase 2 trials in the U.S. to assess pamrevlumab versus standard care in patients with severe COVID-19.
Gilead announced top-line results from its Phase 3 SIMPLE clinical trial (NCT04292899) testing the safety and antiviral activity of remdesivir. According to the results, patients who received remdesivir treatment for five days were 65% more likely to improve clinically at day 11 than those who received standard care.
A preliminary report from 1,059 patients participating in another Phase 3 trial called ACTT (NCT04280705), assessing the effects of remdesivir for the treatment of COVID-19, was published in The New England Journal of Medicine. Early results show that remdesivir was superior to a placebo in shortening the time to recovery in adults hospitalized with COVID-19 and lower respiratory tract infection.
With early data showing that redemsivir may speed up recovery time, certain U.K. patients hospitalized with COVID-19 who meet specific criteria will soon be able to access the investigational therapy. Patients will be selected based on expert clinical advice for greatest potential benefit. The plan is supported by the U.K. government, Gilead, the National Health Service, and the Medicines and Healthcare Products Regulatory Agency. Remdesivir has not yet been approved for any indication.
BerGenBio has dosed the first patient in its Phase 2 trial testing oral kinase inhibitor bemcentinib, along with standard care, in hospitalized COVID-19 patients. The treatment candidate is the first to be selected as part of the U.K.’s Accelerating COVID-19 Research & Development (ACCORD) platform, an initiative designed to rapidly test potential COVID-19 therapies in early trials before sending them into large-scale studies. The trial is recruiting an estimated 120 participants at eight sites across the U.K.
The first patients have been dosed in a Phase 1 trial (NCT04411628) led by Lilly and AbCellera to test an antibody treatment against COVID-19 called LY-CoV55. This marks the world’s first in-human study evaluating an antibody for treating the virus. The randomized, single ascending dose trial is evaluating the safety, tolerability, pharmacokinetics (movement in the body), and pharmacodynamics (effect on the body) of LY-CoV555 administered intravenously in patients hospitalized with COVID-19. The trial, which will enroll an estimated 40 participants, is currently open for recruitment at multiple sites in the U.S. It is expected to be completed on Aug. 23.
An investigational antiviral antibody being developed by Celltrion for COVID-19 has shown positive results in a preclinical study, the company announced. The study tested the efficacy of a high and low dose of the treatment candidate in an animal model. Results showed that the therapy led to a hundredfold reduction in viral load and reduced lung lesions to a normal level.
Advent has manufactured 13,000 doses of AZD1222, AstraZeneca’s experimental COVID-19 vaccine, for use in clinical testing. According to the Italy-based manufacturing company, it delivered 4,000 doses to the University of Oxford for its Phase 2/3 COV002 trial (NCT04400838), which is aimed at testing the potential vaccine in more than 10,000 healthy volunteers. It is not yet open for recruitment.
Massachusetts Eye and Ear and Massachusetts General Hospital have partnered with AveXis to develop a new potential genetic vaccine, called AAVCOVID, against COVID-19. The hospital will conduct safety and efficacy testing in preclinical studies, while AveXis will start manufacturing the vaccine. It will use a gene therapy approach, where a harmless adeno-associated virus will deliver a genetic code to human cells to make portions of SARS-CoV-2, the virus that causes COVID-19, to elicit an immune response.
PureTech will begin human clinical trials to test its experimental treatment LYT-100 (deupirfenidone) in people with respiratory complications following recovery from COVID-19 infections. LYT-100, an analog of the pulmonary fibrosis treatment Esbriet (pirfenidone) is currently being tested in a Phase 1 trial (NCT04243837) in healthy volunteers and patients with breast cancer-related lymphedema for safety, tolerability, and pharmacokinetics.
Results from the first potential COVID-19 vaccine to be tested in a Phase 1 clinical trial (NCT04313127) were recently published in the journal The Lancet. They showed that the adenovirus type 5 vectored COVID-19 (Ad5-nCoV) vaccine was tolerable and able to trigger an immune response as early as 14 days after vaccination. The researchers concluded that the potential vaccine is worth further investigation but cautioned that they are still a long way off from having a COVID-19 vaccine available to all.
Novavax is enrolling the first participants in a Phase 1/2 trial testing its vaccine candidate, NVX‑CoV2373. The trial is being conducted in two parts, the first of which is taking place in Australia and is testing the safety and immune response in healthy volunteers, ages 18 to 59. The Phase 2 portion will be conducted in multiple countries and will include a broader age range to test the vaccine’s safety, immunity, and ability to reduce COVID-19 disease.
Glenmark Pharmaceuticals is launching a Phase 3 trial in India to test if early treatment with favipiravir and umifenovir improves the efficacy of the antiviral combination in hospitalized COVID-19 patients. The trial is expected to enroll approximately 158 participants with moderate COVID-19, who will be randomized to receive favipiravir either with or without umifenovir, plus standard care.
Covis Pharma has announced the start of a Phase 3 trial (NCT04377711) to assess the safety and efficacy of the asthma medication Alvesco (ciclesonide) in people with symptoms of COVID-19, ages 12 and older who are not hospitalized. Researchers think the treatment may suppress viral replication and alleviate symptoms of the disease. The multicenter, randomized trial is expected to recruit 400 participants across the U.S. and is estimated to be completed by the end of the year.
A new trial (NCT04303507) led by the University of Oxford and the Mahidol Oxford Tropical Medicine Research Unit in Thailand is recruiting participants to test the effect of chloroquine and hydroxychloroquine on COVID-19. The randomized trial will enroll an estimated 40,000 healthcare workers across Europe, Africa, Asia, and South America who have had close contact with patients with either proven or suspected COVID-19. There is currently no conclusive proof that either chloroquine or hydroxychloroquine can prevent or treat COVID-19.
Octapharma is launching a Phase 3 trial to test whether Octagam 10%, its intravenous immune globulin therapy, can slow or prevent respiratory deterioration in COVID-19 patients.The multicenter, randomized trial will enroll 54 patients with severe COVID-19 at approximately 10 sites in the U.S. Octagam 10% is an approved treatment for chronic immune thrombocytopenic purpura in adults.
IMV has selected a vaccine candidate against COVID-19 that it plans to advance into in-human studies. The vaccine, called DPX-COVID-19, is based on peptide epitopes that showed robust immune and antibody responses in preclinical studies. The company anticipates launching a Phase 1 trial to test the potential vaccine this summer.
AstraZeneca has finalized agreements for the first 400 million doses of its vaccine candidate being developed by the University of Oxford. It has already secured manufacturing capacity for 1 billion doses and plans to begin the first deliveries in September. The vaccine, called AZD1222, (previously ChAdOx1 nCoV-19) is being tested in a Phase 1/2 trial (NCT04324606) to determine the safety, efficacy, and immune response in more than 1,000 healthy volunteers.
Moderna announced positive interim results from a Phase 1 clinical trial (NCT04283461) testing its potential COVID-19 vaccine mRNA-1273. The trial, led by the National Institutes of Health, is testing three different doses of mRNA-1273 in healthy volunteers ages 18–55 for safety, immune response, and adverse effects. The results so far show that the vaccine is generally safe and well tolerated. Moderna is planning a Phase 2 trial to further test the potential vaccine and determine the right dose to be used in pivotal studies expected to start in July. The Phase 1 trial is still recruiting healthy volunteers in Georgia, Maryland, and Washington.
NeuroRx is sponsoring a Phase 2b/3 trial (NCT04360096) that will test aviptadil in critically ill COVID-19 patients. The goal of the trial is to identify COVID-19 patients with non-acute lung injury and treat them with aviptadil in hopes of preventing progression from non-acute to acute lung injury and acute respiratory distress syndrome, or ARDS, both complications associated with COVID-19. The multicenter, randomized, placebo-controlled trial will recruit approximately 144 participants with COVID-19 and evidence of lung injury. Enrollment is not yet open.
Stanford Medicine is currently enrolling participants in a Phase 2 trial (NCT04331899) testing whether peginterferon lambda-1a can help patients to recover faster and limit viral shedding, which lowers the risk of transmission to others. The open-label, randomized trial is recruiting an estimated 120 participants in California, ages 18 to 64, with an initial diagnosis of COVID-19 and symptoms of respiratory infection without respiratory distress. Peginterferon lambda-1a is an antiviral that has already been tested against viruses that cause hepatitis.
The University of Oxford has launched a trial in the U.K. that will test the ability of existing treatments such as hydroxychloroquine and azithromycin to prevent, slow, or even halt the progression of COVID-19 and reduce the severity of its symptoms, avoiding hospital admissions in people older than 50.
The FDA completed its review of ViralClear’s investigational new drug application for merimepodib to treat adults with advanced COVID-19. This means the company can now start its proposed Phase 2 trial testing the potential treatment. The trial will be randomized, double blind, and placebo-controlled and is expected to be conducted at multiple sites across the U.S. It will test the safety and efficacy of merimepodib in adults infected with SARS-CoV-2 and admitted to the hospital requiring supplemental oxygen.
Interim results from a multicenter, randomized trial in Russia testing Avigan (favipiravir) showed that 60% of the 40 patients with COVID-19 who received the treatment tested negative for the virus after five days, according to the Russian Direct Investment Fund, which is financing the study. The trial is expected to include 330 participants with confirmed COVID-19 at sites across Russia. Avigan is an antiviral first developed in Japan for the treatment of influenza.
Results from an observational study in France show that hydroxychloroquine does not significantly lower admissions to intensive care or death in patients hospitalized with pneumonia due to COVID-19. In addition, a randomized trial in China found that patients with mild to moderate COVID-19 treated with the anti-malarial drug did not clear the virus quicker than those receiving standard care. More adverse events were also recorded in patients treated with hydroxychloroquine. Findings from both studies, published in The BMJ journal, add to growing evidence that hydroxychloroquine may not be effective against COVID-19.
Moderna’s investigational mRNA vaccine for COVID-19, called mRNA-1273, was awarded the FDA’s fast-track designation, the first to receive this status, which is intended to speed up the review time for a potential medication. The company anticipates launching a Phase 3 trial testing the vaccine in early summer.
An observational study conducted by the University of Albany and the New York State Department of Health found no benefit to treating COVID-19 patients with hydroxychloroquine. This is at least the third such study to reach this conclusion, according to the FDA. After reviewing the medical records of 1,438 patients from 25 hospitals in the greater New York area, the researchers found that treatment with hydroxychloroquine, azithromycin, or both did not significantly lower the in-hospital death rate. The study was published in the Journal of the American Medical Association.
rolling out a second Phase 3 trial the safety and efficacy of compared with standard care in patients with COVID-19 who develop . Jakafi is a prescription medication for , , and . The trial will be conducted in the U.S. The companies had previously announced a Phase 3 trial called RUXCOVID, which is examining Jakafi’s effectiveness in treating COVID-19-associated cytokine storm. That trial is currently underway.and are
A new Phase 2 trial National Institute of Allergy and Infectious Diseases, follows on the heels of another study that found that remdesivir on its own shortened patients’ recovery time over a placebo.to investigate the effectiveness of with in treating COVID-19. It is expected to enroll up to 1,000 participants at 100 sites worldwide. Enrollment has already begun in the U.S. Remdesivir is an investigational broad-spectrum antiviral being developed by . It is not yet approved anywhere in the world for any indication. Olumiant is an anti-inflammatory by used to treat some patients with . The trial, being sponsored by the
A Phase 2 trial (combo therapy suppressed the virus at day seven. This was five days earlier than in patients who were treated with Kaletra only. The combo was also found to be safe, leading to minor gastrointestinal side effects such as diarrhea and vomiting.) conducted in China tested a combination of three antivirals, (lopinavir-ritonavir), an antiviral, , a treatment, and , a treatment used in . The trial, completed on March 31, that the
The FDA emergency use authorization for a new laboratory test kit to detect SARS-CoV-2. The kit, called can detect the genetic material of the virus in oral and nasal swabs as well as sputum.
The U.S. Food and Drug Administration has granted Gilead Sciences’ remdesivir emergency use authorization for the treatment of COVID-19, the company recently announced. The agency’s decision was based on available data from two global Phase 3 clinical trials.
Top-line results from one of these Phase 3 trials, known as SIMPLE (NCT04292899), showed that a shorter, five-day course of treatment with remdesivir leads to similar improvements in clinical status as a 10-day course of treatment in patients hospitalized with severe COVID-19. The open-label trial is testing the effects of two dosing durations (five days and 10 days) of the experimental antiviral.
The European Medicines Agency also began a rolling review of remdesivir for COVID-19, with the goal of shortening the review time of the treatment from months to weeks.
The FDA granted emergency use authorization to a new antibody test for COVID-19. The test, developed by Roche, is called Elecsys. It is able to determine with 100% sensitivity and 99.8% specificity whether a person has been exposed to SARS-CoV-2 in the past and developed antibodies against the virus.
The first participants have been dosed in a Phase 1/2 trial in the U.S. that is testing four mRNA vaccine candidates being jointly developed by BioNTech and Pfizer against COVID-19. The first part of the trial is a dose escalation stage that is enrolling up to 360 healthy individuals. The BNT162 vaccine program also includes a similar trial in Germany, which completed dosing of its first group last week.
Massachusetts General Hospital is conducting a clinical study to assess the potential efficacy of inhaled nitric oxide to reverse hypoxemia (abnormally low oxygen levels in the blood) in patients with severe COVID-19. Mallinckrodt Pharmaceuticals is providing both funding and INOmax — nitric oxide gas for inhalation — for the study.
Patients are being enrolled in a Phase 2 trial at Beaumont Hospital in Royal Oak, Michigan, to test a combination of naltrexone and ketamine for treating COVID-19. Researchers will assess whether reducing inflammation with the combo therapy may lessen the severity of COVID-19 symptoms.
AstraZeneca and the University of Oxford are collaborating on developing a potential vaccine against COVID-19 to be developed and distributed globally. The potential vaccine, called ChAdOx1 nCoV-19, is being developed by the University of Oxford and will be manufactured and distributed by AstraZeneca.
German regulatory authority Paul-Ehrlich-Institut approved a Phase 1/2 clinical trial for BioNTech and Pfizer‘s BNT162 vaccine program, which is testing four mRNA vaccine candidates to prevent COVID-19. In the first phase of the trial, researchers will test the vaccines in 200 healthy volunteers ages 18 to 55 to determine the optimal dose. The second part will include participants at a higher risk of severe COVID-19.
Asthma medication MN-166 (ibudilast) will be tested in a clinical trial to assess its potential in treating acute respiratory distress syndrome caused by COVID-19. The trial is a collaboration between Yale University and pharmaceutical company MedicNova.
A trial called STOP-COVID19 is expected to start recruiting up to 300 hospitalized patients with COVID-19 in the U.K. in May to test the experimental treatment brensocatib. Insmed, which is developing the treatment for bronchiectasis and other inflammatory diseases, will provide funding and the medication for the trial, which is sponsored by the University of Dundee.
A new trial funded by Amazon and run by Columbia University will assess whether plasma (the liquid portion of the blood devoid of cells) obtained from COVID-19 survivors can be used to prevent SARS-CoV-2 infections or treat COVID-19. The trial aims to recruit 450 people who have been in close contact with COVID-19 patients such as healthcare workers as well as intensive care unit patients.
Astra Zeneca will test the diabetes treatment Farxiga (dapagliflozin) in a trial to assess its potential to decrease the risk of death from serious complications and organ failure in COVID-19 patients. The trial, which is a collaboration with Saint Luke’s Mid America Heart Institute, will enroll 900 participants in the U.S. and European countries that are experiencing high rates of COVID-19 cases.
An experimental treatment by Vivacelle Bio will be made available for compassionate use in COVID-19 patients. The experimental treatment, called VBI-S, is currently being tested in a Phase 2 trial (NCT04257136) people with reduced blood circulation due to sepsis.
Quest Diagnostics started offering an antibody testing service for COVID-19 on blood samples. The antibody test, intended for healthcare providers, can determine whether a person has antibodies in their blood against SARS-CoV-2, meaning they have been exposed to the virus and may have some level of immunity against it.
Biogen, Broad Institute, and Partners HealthCare are launching a consortium to build and share a COVID-19 biobank. The biobank will contain blood samples of Biogen employees willing to participate in the project who contracted and have recovered from COVID-19. People identified as close contacts of those individuals are also eligible to participate regardless of whether they were confirmed to have COVID-19. The biobank will help scientists understand why some people infected with SARS-CoV-2 become seriously ill while others do not even show any symptoms. A better understanding of the biology of the virus and the response the human body has to it will help speed the quest for potential vaccines and treatments.
Alexion is planning a Phase 3 trial testing Ultomiris (ravulizumab-cwvz) for treating severe COVID-19. The global trial will include approximately 270 hospitalized patients who have severe pneumonia or acute respiratory distress syndrome. Ultomiris is FDA-approved for paroxysmal nocturnal hemoglobinuria and atypical hemolytic uremic syndrome (aHUS).
In the coming weeks, Novartis is planning to start enrollment for its randomized Phase 3 trial testing hydroxychloroquine in hospitalized COVID-19 patients. An estimated 440 patients will be recruited across more than a dozen U.S. sites.
Sinovac has launched a randomized Phase 1 trial in China to test its vaccine candidate against COVID-19. The first group of an estimated total of 144 healthy adults have already been given the first dose of two doses of the experimental vaccine.
The FDA authorized a saliva test for emergency use to diagnose COVID-19. The test was developed by Rutgers University in collaboration with other groups. The test can only be used in a healthcare setting and is not available to purchase for home testing.
LabCorp has received emergency use authorization from the FDA for the first diagnostic test using samples collected from people at home. The at-home kit includes a special cotton swab to collect a sample from the individual’s nose. The sample is then mailed in an insulated package to a LabCorp lab. The products contained in the LabCorp collection kit are the only ones authorized for at-home use at this time.
Biohaven Pharmaceuticals will soon start a Phase 2 clinical trial to test intranasal vazegepant in treating lung complications caused by COVID-19. The trial will run in collaboration with Thomas Jefferson University and other institutions.
The FDA has cleared a Phase 2 trial that will test the safety and efficacy of Hope Biosciences’ adipose-derived mesenchymal stem cells to provide immune support against COVID-19. The trial will enroll an estimated 100 front-line healthcare workers and first responders and will test three doses of cells over 14 weeks.
Vaxil has completed the first preclinical experiment testing its COVID-19 vaccine candidate. According to the results, the vaccine candidate showed a favorable immune response in healthy donor blood cells. The company has now begun the next set of experiments to better understand the immune responses and determine dosing, with additional experiments planned.
Sanofi and GlaxoSmithKline are partnering on developing an adjuvanted COVID-19 vaccine. Sanofi is providing its S-protein COVID-19 antigen, based on a recombinant RNA technology that created an exact match to proteins found on the surface of the virus. GSK will contribute its pandemic adjuvant technology, which is intended to boost the immune response and may lead to a stronger and longer-lasting effect than the vaccine alone. The companies are aiming to launch a Phase 1 trial in the second half of this year.
(high-dose inhaled nitric oxide therapy) can now be tested in patients infected with SARS-CoV02 as part of a Phase 2 clinical trial () that began in 2017 to assess its effects in treating difficult lung infections. and , developers of Thialonax, on April 1 that their joint pilot trial was cleared by the . The trial will now be able to recruit participants infected with SARS-CoV-2 at Vancouver Coastal Health Authority facilities to test the therapy’s safety and effectiveness in treating COVID-19.
The FDA a randomized, double-blind, placebo-controlled Phase 3 trial () to evaluate the safety and efficacy of plus standard of care in hospitalized adults with severe COVID-19 pneumonia. Actemra is an anti-rheumatoid medication by that is also being evaluated in a as a potential treatment for COVID-19.
A Phase 3 trial called RUXCOVID is to evaluate the safety and efficacy of in COVID-19-associated . The medication was developed by and is sold under the brand-name Jakafi for , , and . Two more trials will test ruxolitinib in treating severe acute respiratory syndrome (SARS) caused by COVID-19 () and COVID-19 pneumonia (). The trials will take place in Mexico and in Canada respectively, but are not yet recruiting patients.
Researchers are working on a new RNA-based immunotherapy to treat COVID-19. The potential treatment would be inhaled by patients and produce therapeutic antibodies in the lungs. and to start trials testing the potential treatment by the end of the year.
Several tests for diagnosing COVID-19 have now been granted emergency use authorization (EUA) from the FDA. As of March 31, the Advanced Medical Technology Association estimated that 17 tests had received EUAs, with more in the works. The same day, Bodysphere announced it was rolling out a test that returned results within two minutes, saying it was granted an EUA, but the FDA later refuted that claim. The test at this point has not received any FDA authorization.
The FDA issued a warning last week that it has not authorized any test for people to use at home for COVID-19 and that people should be aware of such fraudulent tests. It also provided a list of fraudulent COVID-19 products including those that claim to prevent or treat the disease.
The agency also announced the creation of an emergency program called the Coronavirus Treatment Acceleration Program to assist in the development of treatments for COVID-19. According to the FDA, as of March 31, it is reviewing 10 therapies already in trials and 15 others in preclinical stages.
Sandoz’s malaria treatment hydroxychloroquine sulfate and Bayer Pharmaceuticals’ chloroquine phosphate have been granted an EUA by the FDA for the treatment of COVID-19. Both companies have donated supplies of the medications to the U.S. Department of Health and Human Services for use. Although clinical trials are needed to prove their efficacy in treating COVID-19, these therapies have shown some benefit in the lab and clinic, according to anecdotal evidence.
Among the trials recently launched for COVID-19 are a global Phase 2/3 trial (NCT04315298) testing rheumatoid arthritis treatment Kevzara (sarilumab) and a U.K.-based Phase 2 trial testing antiviral SNG001, an inhaled formulation of interferon-beta-1a. The first patients have already been treated in both trials. Another Phase 2/3 trial (NCT04315298) testing Kevzara is recruiting an estimated 400 participants in the U.S.
Johnson & Johnson announced plans to start a Phase 1 trial by September to test its vaccine candidate Ad26 SARS-CoV-2 against COVID-19. If the trial is successful, the first batch of the vaccine could be available in early 2021 for emergency use, according to the company.
The CDC has developed a diagnostic panel for use by CDC-qualified laboratories in the U.S. and made available under an emergency use authorization (EUA) from the FDA
Other new tests include Roche Diagnostics’ cobas SARS-CoV-2 test, also granted an EUA, and the U.S. Department of Health and Human Services is funding the development of two other diagnostic tests that can detect the presence of SARS-CoV-2 within one hour.
The National Institute of Allergy and Infectious Diseases is sponsoring a randomized, controlled Phase 2 trial in the U.S. to evaluate the safety and efficacy of the broad-spectrum anti-viral treatment remdesivir by Gilead Sciences to treat the disease. Gilead has also launched two global Phase 3 trials to evaluate remdesivir’s safety and efficacy in adults with COVID-19.
Other treatments being investigated for COVID-19 include a novel mRNA-1273 nanoparticle-encapsulated vaccine (NCT04283461), thalidomide (NCT04273581), sildenafil (NCT04304313), eculizumab (NCT04288713), recombinant human interferon-alpha 1 beta (NCT04293887), bevacizumab (NCT04305106), and antibodies from cured patients (NCT04264858), among others.
Researchers are also looking at new synthetic biology approaches by using self-assembling nanoparticles coated with viral antigens that can precisely target SARS-CoV-2. This approach can potentially overcome some of the limitations of conventional vaccines such as short shelf-life and viral evolution.
What is COVID-19?
COVID-19, short for coronavirus disease 2019, is an infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). SARS-CoV-2 is a newly identified pathogen that has not previously been seen in humans and is highly contagious. Though it belongs to the same category of viruses as SARS coronavirus (SARS-CoV) and influenza viruses, SARS-CoV-2 is a different strain with its own characteristics.
How does COVID-19 spread?
Because COVID-19 is a new virus, nobody has prior immunity to it, meaning the entire human population is prone to infection.
COVID-19 is primarily spread via respiratory droplets when people cough or sneeze. Scientists have yet to understand how easily and sustainably the disease can spread among people. Based on available evidence, researchers do not think that airborne spread is a major transmission route.
Individuals over age 60 are also at the highest risk of developing a severe case of COVID-19, while children do not seem to be at a higher risk than adults.
There are currently no reports about how susceptible pregnant women may be to COVID-19 or about the transmission of the virus through breast milk.
What are the symptoms of COVID-19?
Common symptoms of COVID-19 begin two to 14 days after exposure. They include fever, tiredness, and dry cough. Other symptoms include sputum production, shortness of breath, sore throat, headache, myalgia (muscle pain) or arthralgia (joint pain), chills, vomiting, and nasal congestion. Less frequent symptoms include diarrhea, hemoptysis (coughing up blood from the respiratory tract), and conjunctival congestion.
Most of these symptoms are usually mild, and about 80% of people who get the virus will typically recover without needing any special treatment. However, about 1 in 6 patients become seriously ill and develop breathing difficulties.
What preventive measures should people take?
The following simple preventive measures can help minimize the spread of COVID-19:
- Wash your hands often with soap, lathering both the front and the back of the hands and fingers for at least 15 to 20 seconds. If soap is not available, use a hand sanitizer that contains at least 60% alcohol. The European Centre for Disease Prevention and Control produced a poster detailing effective handwashing.
- Avoid close contact with someone who is ill. (Maintain a distance of at least 6 feet, or 1.8 meters).
- Stay at home if you are sick.
- Use a tissue to cover your mouth and nose if you cough or sneeze and dispose of it properly afterward.
- Disinfect surfaces and objects you touch frequently.
- Avoid touching your eyes, nose, and mouth with unwashed hands.
What extra precautions should people with pulmonary fibrosis take?
Although people with respiratory diseases such as pulmonary fibrosis are not necessarily at a higher risk of contracting COVID-19, they may be more likely to show symptoms and to have a more severe infection than others.
Individuals who are on disease-modifying therapies (DMTs) such as immunomodulatory treatments are also at a higher risk of contracting COVID-19. This is because these therapies weaken the immune system, making patients more susceptible to infections, including COVID-19.
In addition to the general preventive measures listed above, patients with pulmonary fibrosis should:
- Stock up on necessary medications and supplies that can last for a few weeks.
- Avoid crowds and non-essential travel.
- Stay at home as much as possible.
Face masks can filter out respiratory droplets potentially carrying the virus. However, those with prior respiratory problems should only wear face masks when necessary as they can make breathing more difficult.
Most patients with respiratory diseases will likely recover from COVID-19. If symptoms of a viral infection appear and patients have traveled to a high-risk area in the past 40 days, they should self-isolate at home for 14 days. They should maintain their daily care regimens and speak to their healthcare providers if they show any COVID-19-like symptoms and for any specific queries about their personal health.
Advice for family members and caregivers
Family members and caregivers of people with chronic diseases such as pulmonary fibrosis should take appropriate precautions and take extra care to avoid bringing COVID-19 home. They should constantly monitor patients and stock medicines and other necessary supplies that can last for several weeks. Storing extra non-perishable food can help minimize trips to the grocery store.
People who show symptoms of COVID-19 should avoid visiting their family members in nursing homes or other places until the self-isolation period is complete.
What should sick individuals do?
If symptoms are present and a COVID-19 diagnosis is confirmed, patients should follow these steps to prevent the spread of the infection:
- Stay at home, preferably in a separate room not shared with others, and isolate yourself, with the exception of getting medical care.
- Avoid public areas and public transport.
- Limit contact with pets and animals.
- Avoid sharing personal items.
- Cover coughs and sneezes with tissues and dispose of them properly.
- Sanitize hands regularly.
- Disinfect surfaces such as phones, keyboards, toilets, and tables.
People should call ahead before visiting the hospital for an appointment. This way, the hospital can take necessary steps to prevent the spread of the infection.
Patients who have confirmed COVID-19 should wear face masks when going out. Healthcare professionals and caregivers working with COVID-19 patients should also wear face masks. The World Health Organization (WHO) has a resource explaining the proper use of a face mask.
What tests are available?
Many tests for the detection of COVID-19 have been made available under the FDA’s emergency use authorization, including rapid tests that are being developed to detect the presence of the virus within minutes.
Is there a treatment?
There are currently no vaccines available for human coronaviruses including COVID-19. This makes the prevention and containment of the virus very important.
Are there new treatments in the pipeline?
Several clinical trials have been launched or are being planned to test a variety of potential treatments and vaccines for COVID-19. A complete list of all ongoing clinical trials pertaining to the virus is available here.
Pulmonary Fibrosis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.