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Infectious disease


Lilly’s COVID-19 antibody treatment reduces death, hospitalizations

Company officials hope clinical trial results will spur use of antibody products

by Megha Satyanarayana
January 28, 2021 | A version of this story appeared in Volume 99, Issue 4


Eli Lilly and Company is hoping that its recent clinical trial results will turn the tide on COVID-19 antibody treatments, a first-line therapeutic for people with mild or moderate disease that some clinicians have been hesitant to use.

A photo of a vial of bamlanivimab, a COVID-19 treatment.
Credit: Eli Lilly and Company
Lilly announced promising results of a combination antibody therapy for treating COVID-19 that includes bamlanivimab.

Lilly officials say a Phase 3 clinical trial found that treating people with COVID-19 with a combination infusion of bamlanivimab and etesevimab reduced the risk of hospitalizations and deaths by 70% compared to people who did not receive the combination therapy. The officials also say the antibodies reduced the amount of virus in people’s bodies and helped people recover from symptoms faster.

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Prathit Kulkarni, an infectious disease doctor at Baylor College of Medicine, says the information provided by the company looks promising, but like others, he wants to see the full scientific report.

“It’s quite encouraging,” Kulkarni says. “They have a big trial of 1,000 people, and they have the primary outcome being hospitalization and death, which are the things you are really trying to avoid from the standpoint of clinical treatment of COVID.”

Lilly has an emergency use authorization (EUA) for bamlanivimab, and has applied to the US Food and Drug Administration for an EUA for the combination drug. The company also announced that it is testing bamlanivimab in combination with VIR-7831, an antibody developed by Vir Biotechnology and GlaxoSmithKline. Regeneron also has a combo treatment, which was given to former President Donald J. Trump when he tested positive for COVID-19 in late 2020.

During an investor call to discuss the Phase 3 data, Lilly’s chief scientific officer, Daniel Skovronsky, talked about some of the factors behind the slow uptake of bamlanivimab. The drug is an infusion and must be given in a specialized setting that maximizes infection control. He also noted that skepticism surrounding antibody treatments probably stemmed from missing clinical trial data. Drugs that are given EUAs are still experimental; trial data is coming in, even as the drug is being administered.

“We’ve had to react quickly, often with partial information. That’s what we asked people to do based on our Phase 2 data,” Skovronsky said on the call. The results of the dual antibody study are similar to what the company has seen with bamlanivimab alone. “Now I think we’ve closed that gap. We expect to see utilization increase quite dramatically.”

Bamlanivimab is a monoclonal antibody that recognizes a portion of the spike protein on SARS-CoV-2, the virus that causes COVID-19. Etesevimab binds to the receptor binding domain of SARS-CoV-2, a part of the spike protein that interacts with the angiotensin converting enzyme ACE-2 on human cells to start the infection process. Together, the antibodies neutralize infection of new cells.

Kulkarni says he agrees with Skovronsky on the reasons for slow adoption of antibody treatments. He uses hydroxychloroquine as an example of a treatment that was given to many people while trials were in progress and turned out to do more harm than good.

Cody Purish had some of those concerns, but opted for bamlanivimab treatment anyway. The 23-year-old was diagnosed with COVID-19 in early January, and watched nervously as the IV dripped the single antibody treatment into his vein.

Purish is a health care worker, and says he knew about the pros and cons of the treatment. But given how felt—nausea, vomiting, terrible body ache that made even small walks around the house unbearable—it was worth a try. So he sat in a recliner in a makeshift infusion unit in his North Carolina hospital, drank some water to pass the time, and hoped for the best. About two or three days later, he started to feel better. He’s pretty sure the antibody helped.

“It hits you like a ton of bricks,” Purish says of COVID-19. “I don’t wish it on my worst enemy.”


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