Keep your family healthy | Top medical experts educate and help
Home » Coronavirus » Monoclonal antibody-based therapy and prevention of COVID-19 infection. (6)
Monoclonal antibody-based therapy and prevention of COVID-19 infection. (6)
“There are three classes of approaches that come down to antibodies to treat COVID-19”:
Return to Expert Center
Antibody-based therapies, as you mentioned, can be very effective. A serum from recovered patients is being tried right now in China and in some other areas. But that’s a general kind of a serum containing many types of antibodies. As far as I understand these are not the medications that you are discussing. Monoclonal antibodies are produced in cell culture. There’s actually three classes of approaches that come down to antibodies to treat COVID-19. There’s the use of convalescent serum from individuals who had been sick, who are now well. That serum and the antibodies from that serum can be isolated and used for individuals who are sick. That can be effective, but it’s not scalable. Serum from recovered COVID-19 patients has been applied to individuals who are not quite sick. So again, in sick COVID-19 patients, it’s not clear that the coronavirus drives the disease. The second class is where we make recombinant antibodies. We identify antibodies that are very good at neutralizing the coronavirus and then produce them at scale in the laboratory. And monoclonal antibodies against coronavirus would be quite effective because we know where antibodies are targeting. And we know their properties. And it’s just a matter of getting them produced. And then, the final category of antibody-based therapy for COVID-19 is vaccines. I’m sure you’ll get to the category of vaccines. The goal is to induce the individual to make their own antibodies. And to make antibodies in a way that they’re producing very good antibodies, and trying to avoid producing not so effective or even harmful antibodies. Indeed, antibodies against COVID-19 could be used as a prophylactic, as a preventative. It’s true especially for the frontline healthcare workers who are probably being exposed to large doses of the coronavirus. It seems that there is data that coronavirus dose at the initial infection could correlate with the severity of COVID-19 disease. Hence the deaths of some young physicians and nurses, of course. The dose of coronavirus certainly matters. That is for sure. And antibodies, I think, at a high enough concentration, at a reasonable concentration, would protect from infection, and certainly lower the severity of any disease or any little infection that got through. I’d also mention that these [protective] antibodies can and should be thought of for individuals who do not make good responses to vaccines. That’s typically the elderly and the immune-compromised. So many of us are familiar with the idea of the flu vaccine that we inject every year, hopefully. Flu vaccines are not so effective in the older population where they where they’re most needed. And that’s also true for individuals who, for one reason or another, don’t make a good antibody response. And those individuals will not typically have a good response. Especially to the early forms of the vaccines that will be available. And so the production of recombinant antibodies and antibody-like molecules will serve as an important way of protecting those populations while they also serve as prophylaxis for our healthcare workers. So I would certainly emphasize that class of therapeutics and prophylactics. As we’re moving forward, how far are we from seeing something at least applied in perhaps the emergency authorization or the first-in-humans kind of clinical practice? Yes. So the antibodies, like every other drug, have to go through three clinical phases of clinical trials. The expectation is that they would pass the safety phase and probably the efficacy phase with flying colors. So the hope is that manufacturers of these antibodies accelerate their good manufacturing practices and safe production infrastructures – so that they can anticipate success with the clinical trials and be ready with large-scale amounts of these antibodies as they pass these clinical trials. So, I think, for any company, there’s a risk associated with scaling up the manufacturing of a drug. And that risk is associated with the possibility that it will fail a clinical trial. But again, because of the safety and the probable efficacy of antibodies, particular kinds of antibodies, I hope anyway. I’m reasonably certain that they can develop their manufacturing processes in parallel with the clinical trials. So that’s still a scale of six months or a year? That’s the scale: six months, half a year. But if I were to guess, I would think that antibodies and antibody-like molecules could have some impact in between drugs. The first drugs will likely carry some difficulties. A vaccine will also carry difficulties. Vaccine will be difficult to prove efficacy, more difficult to prove efficacy [than drugs]. And vaccines will not be, even in the best cases, especially effective for individuals whom you worry about most – meaning the elderly, and the immune-compromised.
How can patients avoid mistakes when dealing with a medical problem? Leading doctors share wisdom: