What are the targets of therapeutics being tested in current Covid-19 clinical trials?
Currently, many different clinical trials that share the common goal of identifying potential treatments that could help to reduce some of the burden caused by infections with Covid-19 on both the individual patient and the healthcare system are underway. Some of the therapeutics used in these trials aim to directly interfere with virus replication whilst others specifically target the overexuberant immune response that has been seen in many patients who test positive for Covid-19. Some trials aim to target both aspects at the same time and there are also over 100 vaccine candidates in varying stages of preclinical testing.
What trials are planned or being undertaken that include targeting aspects of viral entry, replication, or propagation?
In terms of studies that are specifically testing therapeutics that directly target some aspect of the Covid-19 virus replication process, Glenmark Pharmaceuticals have begun a Phase III trial of the anti-flu drug favipiravir and Roche have begun a Phase III study of Gilead Sciences remdesivir in combination with Actemra/RoActemra, the latter two of which specifically target aspects of the immune response. Furthermore, Atriva Therapeutics is conducting a Phase II study of ATR-002 for the treatment of moderate to severe Covid-19 infection in patients who have contracted the virus and require hospitalisation. In preclinical studies, ATR 002 has been demonstrated to inhibit Covid-19 propagation and reduce the cytokine storm immune cascade. BerGenBio is also conducting a Phase II trial bemcentinib, which is an inhibitor of AXL kinase that has shown potential utility against the cell entry stage of infection for several enveloped viruses, including Covid-19, in preclinical studies.
Multiple studies have also been initiated to test the utility of drugs commonly used to treat rheumatoid arthritis in patients with Covid-19. Eli Lilly and Keck Medicine are conducting separate studies of the JAK1/JAK2 inhibitor baricitinib. It is thought that baricitinib may have the potential to inhibit viral infection by binding to AP2-associated protein kinase 1, which would reduce viral entry into cells as well as targeting the subsequent inflammatory process.
What trials are planned or being undertaken that focus on targeting the overexuberant immune responses seen in Covid-19 patients?
Many trials are being conducted to explore the potential benefits of targeting the overexuberant immune response seen in most patients who test positive for Covid-19. Aerpio Pharmaceuticals and Quantum Leap Healthcare Collaborative have joined forces to assess whether razuprotafib, which bocks vascular endothelial protein tyrosine phosphatase, activates Tie 2 and subsequently causes stabilisation of vasculature, may be useful in Covid-19 positive patients with acute respiratory distress syndrome (ARDS). MediciNova is testing the efficacy of ibudilast and Cynata Therapeutics are testing the efficacy of cymerus mesenchymal stem cells against ARDS in Covid-19 positive patients.
Covis Pharma has also initiated a Phase III clinical trial to evaluate the potential utility of Alvesco, which is normally used to manage asthma, in the treatment of non-hospitalised, symptomatic Covid-19 patients aged 12 years and above. Furthermore, GSK is also preparing to trial an investigational rheumatoid arthritis drug otilimab in the treatment of pneumonia caused by Covid-19 infection. It is thought that otilimab may be able to interfere with the inflammatory cytokine cascade triggered by the virus.
Which Covid-19 vaccine trials are currently receiving a lot of interest?
Whilst there are many vaccine candidates in various stages of preclinical testing, two have recently shown a lot of promise. The Moderna mRNA-1273 vaccine, which is based on the Covid-19 spike protein, has recently entered Phase II trials. The Oxford University ChAdOx1 nCoV-19 vaccine, which is based on the use of a weakened version of the common cold virus that has been modified to carry the Covid-19 spike glycoprotein, has recently entered Phase II/III trials.
Are there any other approaches to controlling the spread of Covid-19 being investigated?
Most notably, the UK-based charity Medical Detection Dogs is looking into the possibility that dogs could be trained in the future to detect individuals who are infected with Covid-19, even if they are asymptomatic.
Where does Bham Pharma fit in?
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