The US government’s biomedical research agency is preparing to test several medications as possible treatments for the new coronavirus epidemic, including Gilead Sciences’ remdesivir.
The National Institute of Allergy and Infectious Diseases (NIAID) “is preparing protocols for in vitro and in vivo studies of the antiviral remdesivir, which has shown promise against other coronaviruses in animal models”, an official at the agency said.
NIAID, a unit of the National Institutes of Health (NIH), is also moving to evaluate “other antivirals in preclinical and clinical development through similar studies”, as well as approved drugs including lopinavir and ritonavir, two antiretroviral components of the pharmaceutical company Abbvie’s HIV drug Kaletra, the NIAID official said.
The institute’s use of remdesivir, which was initially developed to fight the Ebola virus, follows China’s decision last month to patent the use of remdesivir to fight Covid-19, the official name for the illness caused by the coronavirus that first sickened people in Hubei province.
The Chinese move has raised questions about who would have control over the use of the drug if it proves effective in treating the new disease.
The state-backed Institute of Virology in Wuhan, the provincial capital where the contagion began to spread in December, filed the patent in China. The application is still pending there. Remdesivir has not been approved anywhere globally.
Gilead is working with Chinese health authorities on a clinical trial for patients with pneumonia-like symptoms to test the drug’s safety and efficacy, the company’s chief medical officer Merdad Parsey said on January 31.
The first coronavirus patient in the United States, who was hospitalised in Washington state after returning from China, was treated with remdesivir in late January and his symptoms improved, according to The New England Journal of Medicine.
The NIAID official said the agency was also planning to test interferon-beta for efficacy against the coronavirus and “is working with multiple developers to isolate and identify monoclonal antibodies that can potentially be used to prevent or treat infection”.
Meanwhile, the Beijing Municipal Health Commission announced last month that three of the city’s hospitals were using lopinavir and ritonavir to treat patients infected by the coronavirus.
“Remdesivir is a rational choice for testing,” said Gary Whittaker, a Cornell University professor of virology. “There is robust pre-clinical data to show the effectiveness of this and related compounds against coronaviruses.”
“There is much less rationale for the use of Kaletra [lopinavir/ritonavir],” he added. “These are protease inhibitors, and while both retroviruses and coronaviruses express proteases, these are distinct enzymes.”
Health authorities are also working to find a vaccine for Covid-19, although an effective one is seen months away, if not more.
Today we activated a @UN Crisis Management Team, to be led by @DrMikeRyan. to ensure @WHO focuses on the response to #COVID19 while other agencies bring their expertise on the social, economic and developmental implications of the outbreak. https://t.co/pfBqWXdXkJ
— Tedros Adhanom Ghebreyesus (@DrTedros) February 11, 2020
World Health Organisation Director-General Tedros Adhanom Ghebreyesus said in Geneva on Tuesday that a vaccine for the contagion might still be 18 months away.
Speaking separately on Tuesday, at a forum organised by the Aspen Institute think tank in Washington, Anthony Fauci, the director of the US Centres for Disease Control and Prevention’s National Institute for Allergy and Infectious Diseases, cautioned that even after a vaccine has been developed, it would need to go through a six-to-eight month testing programme.
And then production would be challenging, he added.
“If it does work, then you have to be able to scale up to make the tens and hundreds of millions of doses, that amount of time is going to be as problematic as getting the vaccine itself going,” Fauci said.
“So that’s the reason why we say even though we’re going into a trial in three months, and we’ll have some data in six months, a vaccine as part of the deployable countermeasure is not in the mix, for at least a year.”
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This article was first published in the South China Morning Post.