Lilly Blazes a trail in Covid-19 prevention

Antibodies, already authorised to treat mild to moderate Covid-19, could soon also be used to prevent the virus, a study of Lilly’s bamlanivimab in nursing homes suggests. To be eligible for the trial, called Blaze-2, nursing homes had to have had at least one confirmed coronavirus case. Across residents and staff receiving bamlanivimab, there was a 57% reduction in the risk of developing symptomatic Covid-19 compared with those receiving placebo. Among residents the figure was even more impressive, with an 80% reduction with bamlanivimab versus placebo. Lilly plans to speak to regulators about expanding bamlanivimab’s EUA; however, there are questions about the role of the antibody if the vaccine rollout goes well. The logistics of infusing nursing home residents on a large scale might be also be tricky. Other antibody developers are looking at prevention, and a notable player here is Astrazeneca with AZD7442, a long-acting antibody. This is given intramuscularly, which could give it an edge over bamlanivimab and Regeneron’s casirivimab/imdevimab, which are both intravenous. Glaxosmithkline also has a long-acting project, the intravenous VIR-7831, but that does not appear to be in any prevention studies; the pivotal Comet-Ice trial in outpatients is set to read out this quarter.

Selected prevention studies with Covid-19 antibodies
Project Company Trial Setting Data?
Bamlanivimab (LY-CoV555)* Lilly/Abcellera Blaze-2**(NCT04497987) Prevention in nursing home residents and staff Positive data reported
Casirivimab + imdevimab (REGN-COV2)*** Regeneron Study 2069 (NCT04452318) Prevention in household contacts of Covid-19 patients Due H1 2021
AZD7442 Astrazeneca Provent (NCT04625725) "Pre-exposure prophylaxis" Due H1 2021
Storm Chaser (NCT04625972) "Post-exposure prophylaxis"
*Trial also includes combo with LY-CoV016 in treatment; **Conducted with NIAID; ***Subcutaneous formulation. Source: clinicaltrials.gov & EvaluatePharma.

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