A Coronavirus Treatment Worth Watching

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(Bloomberg Opinion) -- As the coronavirus crisis has unfolded, we’ve seen a flood of announcements from drug companies touting potential treatments for the still incurable disease. Many have come from biotechnology companies that have never successfully developed a drug, let alone purpose-built one for an outbreak. Regeneron Pharmaceuticals Inc.'s announcement Tuesday that its development efforts are ahead of schedule — so much so that it may be able to start human trials in early summer — is an exception that should provoke measured optimism.

There's still a long road ahead and a lot of uncertainty. Even in a best-case scenario, a drug won't be tested for months and broad availability is even farther away. But if Covid-19 sticks around, there's at least a chance a Regeneron drug will be a tool used to fight it. In addition to developing blockbuster medicines, Regeneron has a demonstrated ability to respond to outbreaks.

The company’s efforts are centered on using mice engineered with human-like immune systems and rapidly developing the antibodies they generate into human medicines. The company created a trial-ready Ebola cocktail in about a year in response to a 2014 flareup of the disease, but the drug didn’t make it to market in time to help before the outbreak subsided. The medicine stayed on the shelf until Ebola emerged again in 2018, and it was sent to Africa to for testing alongside several other drugs. Only 29% of those who took Regeneron's drug died throughout the trial, compared with a mortality rate of about 50% for people who took two less effective medicines. One of the medicines it beat by a significant margin was Gilead Sciences Inc.'s remdesivir, which has shown early promise as a Covid-19 treatment.

An additional advantage of Regeneron's approach is that it's intended to lead to a drug that could serve as both protection against the virus and treatment for active cases. This duality may help it get to patients faster; acute treatments have a lower safety bar and require less study than medicines intended for extensive protective use.

The company's timeline for a Covid-19 treatment is faster than what it's managed in the past; that’s in part because its team is working with more experience. Still, there's no guarantee of success, and what is considered “rapid” by the standards of drug development will still feel slow as U.S. cases grow in the next few weeks.

A best-case scenario requires Regeneron to hit multiple ambitious targets, including that the drug will work when others developed over a more extended period fail, that it will get the nod from regulators, and that the company will be able to quickly build the manufacturing capibility to produce it. If every mark is hit, the drug could conceivably see limited use sometime in the fall. The more likely scenario — especially when it comes to crucial preventative use — is that it takes longer.

That may not seem like much of a win as cases mount every day. Keep in mind, however, that the most ambitious timeline for a vaccine is 12 to 18 months, and that the most promising interim options are repurposed. A novel remedy any time this year would still be unprecedented, and with many drug companies having moved away from infectious diseases, it may be essential.

This column does not necessarily reflect the opinion of Bloomberg LP and its owners.

Max Nisen is a Bloomberg Opinion columnist covering biotech, pharma and health care. He previously wrote about management and corporate strategy for Quartz and Business Insider.

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