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Regeneron Announces Encouraging Initial Data from COVID-19 Antibody Cocktail Trial

By HospiMedica International staff writers
Posted on 04 Jan 2021
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Image: A scanning electron microscope image of SARS-CoV-2 (round blue objects) (Photo courtesy of NIAD)
Image: A scanning electron microscope image of SARS-CoV-2 (round blue objects) (Photo courtesy of NIAD)
Regeneron Pharmaceuticals, Inc. (Tarrytown, NY, USA) has announced encouraging initial data from an ongoing Phase 1/2/3 clinical trial of the Regeneron antibody cocktail, casirivimab and imdevimab, in hospitalized COVID-19 patients requiring low-flow oxygen.

The clinical and virological analyses include data from the Regeneron-sponsored trial evaluating hospitalized patients who were on low-flow oxygen (defined as maintaining oxygen saturation of >93% via nasal cannula, simple facemask, or similar device), including 217 who were seronegative when they entered the trial and 270 who were seropositive; although seronegative patients comprised less than half of the trial population, based on placebo rates they account for approximately two-thirds of the deaths in the absence of antibody cocktail treatment. Patients were randomized to receive the antibody cocktail (either 8,000 mg high dose or 2,400 mg low dose) or placebo, in addition to standard-of-care therapies, with 67% receiving remdesivir and 74% receiving systemic corticosteroids. Similar clinical and virologic efficacy was observed for the high and low doses of the antibody cocktail. Both antibody cocktail doses were well-tolerated. In the overall trial population, the incidence of serious adverse events was 21% for high dose, 20% for low dose and 24% for placebo. Infusion reactions were more common with the high dose of the antibody cocktail (2.7% high dose, 0.9% low dose, 1.4% placebo) and there were two discontinuations due to infusion-related reactions, both of which occurred in the high dose group.

"These preliminary results in hospitalized patients, as well as data from the previously announced outpatient trial, indicate that antibodies produced by a patient's own immune response are important to control COVID-19 infection. In this trial, patients who had not yet mounted their own immune response had much higher viral loads and much worse clinical outcomes; for example in the placebo group, seronegative patients were almost three-times more likely to die compared to seropositive patients," said George D. Yancopoulos, M.D., Ph.D., President and Chief Scientific Officer at Regeneron. "Moreover, the data from these trials in hospitalized and non-hospitalized patients suggest that Regeneron's antibody cocktail may compensate for an inadequate endogenous antibody response by reducing viral levels and the risk of adverse clinical outcomes. It is important to remember that while the virology results from this analysis of hospitalized patients were robust, the clinical efficacy data are based on a small data set of events and cannot be viewed as conclusive at this stage. A much larger trial will be required to rigorously characterize this effect and we believe the ongoing UK-based RECOVERY trial will provide those answers. It has already enrolled more than 2,000 hospitalized patients in the part of the trial evaluating adding the antibody cocktail to standard-of-care compared to standard-of-care alone."

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