COVID-19 Drug Development: What’s promising in the pipeline?
With the future of the world at stake, pharmaceutical researchers have been racing, since March, to find a way to cure or prevent COVID-19. That urgency to develop an effective treatment or vaccine has produced some encouraging results with new and existing drugs. While a sure-fire cure hasn’t yet been discovered, the advances that have been made may provide therapeutic benefits as well as a strong foundation for future research. Ongoing studies, tests, and clinical trials each move us that bit closer to stopping, slowing, and preventing COVID-19.
This month’s featured research articles report on promising drug candidates, emerging treatments, and the Solidarity clinical trial, an international initiative launched by the World Health Organization and partners to find an effective treatment for COVID-19. The articles provide important insights and experimental evidence that will advance understanding of this viral disease and help direct future studies. To that end, please feel free to read, share, and build on the research below.
While researchers don’t fully understand how the SARS-CoV-2, the virus that causes COVID-19, interacts with human cells, they have made a lot of progress in a short time. This article reports that an international collaboration of 22 labs in the U.S., France, and the U.K. have already identified at least 332 interactions between viral and human proteins and the 29 potential treatments that the Food and Drug Administration (FDA) has approved. All told, the collaboration among over 100 researchers has already produced 12 drugs in the clinical trial stage and 28 in the preclinical development stage.
Research Yields Hope
The most promising drug to come out of that effort is an experimental anticancer drug called PB28, which was found to be 20 times more powerful at deactivating the virus than hydroxychloroquine, apparently without the harmful effects of the latter. More encouraging results are also reported in a study published in the Antimicrobial Agents and Chemotherapy, a journal of the American Society for Microbiology, where researchers affiliated with the Zoonotic Virus Laboratory, Institut Pasteur Korea, have uncovered two more FDA-approved drugs -- niclosamide and ciclesonide – that demonstrate positive antiviral activity against SARS-CoV-2. Niclosamide, typically used against parasites, is quite effective in lab animals against COVID-19, but may not be sufficiently absorbable to reach theraputic levels in humans. Further drug formation is likely required. Ciclesonide, commercially known as Alvesco, is also promising, although its antiviral benefits may not be as potent as niclosamide’s. An inhaled corticosteroid with proven anti-inflammatory effects, it is used to treat asthma and allergic rhinitis, and could play a critical role in preventing or calming cytokine storms, which are immune inflammatory overreactions among COVID-19 patients.
Solidarity on Remdesivir
A broad-spectrum antiviral medication developed by Gilead Sciences, Remdesivir was evaluated for efficacy in treating SARS-CoV-2. In April 2020, with three other medications (Lopinavir/ritonavir combined, Lopinavir/ritonavir combined with interferon-beta, and Hydroxychloroquine/chloroquine) already approved for other diseases, as part of the International Solidarity trial.
Launched by the World Health Organization (WHO) and partners, the international Solidarity trial enrolled individuals from multiple countries to determine if the drugs slow disease progression or improve survival among COVID-19 patients. So far, the results on remdesivir are encouraging and the investigations into Hydroxychloroquine/chloroquine were discontinued in June 2020.
Small Molecule Drug, Abivax, ABX464
France’s National Agency for the Safety of Medicines (ANSM) and French Ethics Committee (CPP) recently approved Phase IIb/III clinical trial of ABX464. Easy to use, self-administered, and developed by Abivax, ABX464 is expected to be helpful in treating cytokine storm and hyper-inflammation syndrome. Phase IIb/III trials are launching, testing elderly patients with COVID-19 at 50 hospitals across France and other European countries to determine its effect on the use of high-flow oxygen or assisted ventilation, as well as on fatality outcomes.
COVID-19 Vaccine Development
The COVID-19 vaccine tracker reports that there are currently over 190 vaccines under development, one of which is AstraZeneca’s AZD1222. Phase I/II clinical trials began in second quarter 2020 to assess its safety, immunogenicity, and efficacy in more than 1,000 U.K. volunteers, aged 18 to 55 years.
Otherwise known as ChAdOx1 nCoV-19, the vaccine was developed by Oxford University’s Jenner Institute, in partnership with the Oxford Vaccine Group. It contains the genetic material of SARS-CoV-2 spike protein to produce a surface protein that promotes the immune system to attack any COVID-19 encountered. The occurrence of an immune response in vaccine recipients to the COVID-19-virus is very encouraging. The researchers hope to complete phase 3 trials by September 2020, which is a mere 9 months since the start of the group’s research. The researchers, however, acknowledge that it may take longer for the vaccine to gain approval for public use.
A recent report indicates that the new vaccine will be manufactured in India for $3 per dose. Countries such as Australia are also securing deals with AstraZeneca to lock in vaccine supplies for their citizens.
Inexpensive Steroid Cuts Down on COVID-19 Deaths
Dexamethasone, a common, low-cost steroid was found to reduce the risk of death by up to one third in hospitalised patients with severe COVID-19 respiratory complications. This is a finding from the ongoing RECOVERY (Randomised Evaluation of COVid-19 thERapY) trial, which began in March to test a range of potential treatments for the disease on over 11,500 U.K. patients.
This major breakthrough, described in a news article COVID-19 by Professor Peter Horby, the University of Oxford researcher who led the trial, claims that dexamethasone is “the first drug [shown] to improve survival in COVID-19.”
For further reading, explore the latest articles from Bentham Science journals for the latest research on drug development for several diseases (including COVID-19):
- Current Pharmaceutical Design
- Current Medical Chemistry
- Anti-Infective Agents
- View the Bentham Science coronavirus article collection here