A novel medication is showing promise in keeping vulnerable Sydney residents infected with COVID-19 (Chinese Communist Party Virus or CCP Virus) from dying or needing to be hospitalized.
Doctors are reporting early successes with sotrovimab on patients with a higher risk of developing severe COVID symptoms as the expected rush of coronavirus patients reaches the hospitals.
The Australian drug regulator, the Therapeutic Goods Administration (TGA), gave provisional approval for sotrovimab, made by pharmaceutical company GSK.
“No patient who was treated with sotrovimab ended up on a ventilator or in ICU, compared to a placebo, where those outcomes were seen,” Dr. Krystal Evans from GSK told 9News.
Over the past three weeks, individuals who met requirements at major hospitals across Greater Sydney have been provided the monoclonal antibody administered by intravenous infusion.
“This is the first drug for which there is really good evidence that it can actually keep people out of hospital in the first place,” Dr. David Andresen, a specialist in infectious diseases at St Vincent’s Hospital, Sydney, said.
“We started using it really as quickly as we can because obviously the hospital system is under quite a lot of stress at the moment so anything we can do to keep patients out of hospital and prevent them needing admission is obviously a good thing.”
Prof Paul Griffin, director of infectious diseases at Mater Health Services, a medical practice company based out of Queensland, Australia, said it is the first treatment for mild COVID, with previous treatments focusing on those in a critical state in hospital, The Guardian reported.
“Sotrovimab is an antibody treatment, and one that’s been shown in good clinical trials to have a dramatic impact in reducing people’s probability of progressing to severe disease,” Griffin said. “If there’s someone who’s high risk at developing severe symptoms, it can be given to them. It does need to be given early, before people are very unwell, but in those people it stops very significant progression through to severe disease.”
New South Wales patients must meet specific requirements, including receiving treatment within five days of the onset of symptoms, not requiring oxygen supplementation, and having risk factors such as age, diabetes, kidney illness, heart failure, or obesity.
Sotrovimab works by binding to the spike protein on the virus using manufactured monoclonal antibodies based on natural ones made by the human body. The capacity of the virus to enter cells, multiply, and disseminate throughout the body is dependent on this protein. Sotrovimab prevents this from happening.
In clinical trials, those who received a single dose had a 79 percent lower chance of hospitalization or death.
Sotrovimab is already being administered to vulnerable adults over 55 with health risks, as well as those under 55 with substantial comorbidities like diabetes or kidney disease, according to Griffin.
“Those people obviously are at very significant risk of getting severely unwell with Covid,” he said. “In the first five days, before they get very sick and before they need oxygen, that antibody can reduce their chance of progressing to requiring hospitalization.
“It is being used now, and is modifying the disease trajectory in the highest risk people. Unfortunately there are still some supply constraints around this medication, but it will help a lot, as until now we haven’t had any highly effective, specifically antiviral medications.”
Griffin said it would have a knock-on effect of lessening the load on hospitals, particularly intensive care units.
“This drug will mean even if we have a lot of Covid cases, if we target the drug at those most at risk we’ll have fewer people clogging up the hospital system and utilising those precious limited resources and so it could, potentially, make the virus much more manageable,” Griffin continued.
“The data from the overseas trials were really very promising, suggesting that you can reduce a patients risk of needing to go to hospital by about three-quarters,” Dr. Andresen said.
Sotrovimab, Australia’s first monoclonal antibody treatment for the CCP (COVID)virus, has been used for a longer time internationally, but new data on its use during our current outbreak will be collected.
It’s not cheap—each dose costs more than U.S.$2,000–but it’s free to patients in Australia’s public health system.
According to doctors, it could be indicated for eight to fifteen percent of individuals with COVID-19.
Other advanced anti-inflammatory drugs, such as tocilizumab and baricitinib, are being tested on ventilated patients, albeit the latter is in short supply in Australia. According to Australian clinical care guidelines, these medications “probably” reduce the risk of death in critical patients, but additional research is needed.
The guidelines also conditionally support using the antiviral drug remdesivir in hospitalized adults with moderate to severe COVID, who do not require ventilation as it “probably” reduces the risk of death. The guidelines do not recommend it be used in adults who do require ventilation.
On the other hand, the World Health Organization advises against using remdesivir in hospitalized patients, regardless of disease severity. The disparity in recommendations stems from differences in how WHO and Australian authorities analyze data, but Griffin claims that clinical experience with remdesivir has shown it to have generally poor results.
“But the addition of anti inflammatory medicines like dexamethasone and tocilizumab have certainly made a difference,” he said.
“Over time, though, I think there will be lots more treatments added for Covid-19. We would like to see a highly active, Covid-19-specific antiviral that could be used orally. That would be a highly desirable tool which we don’t have yet. But lots of promising research is happening, and in the near future, I expect we will have a larger range of treatments available.
“In the meantime we have already come a long way in our understanding how the disease progresses, and with more people vaccinated combined and the addition of sotrovimab, the situation is being helped a lot.”