It was the Oxford-based Recovery trial that proved steroids saved the lives of some Covid-19 patients, and it will now take on promising but much more expensive new antibody combination treatments, it has been announced, and reported on by The Guardian.

What will happen? A cohort of patients joining the trial in most NHS acute hospitals will be randomly allocated to Regeneron’s experimental drug. This is called REGN- COV2. The drug is a combination: two human neutralising antibodies against the virus. The same company previously developed a similar antibody drug that was used to fight against Ebola.

Unlike dexamethasone, the drug that Recovery proved saves the lives of one in eight acutely ill patients, the new drug has been invented specifically for the coronavirus pandemic that we’re all living through right now.

The drug has come through animal studies and a phase one safety trial—though it’s now in late stage trials in the United States.

Peter Horby is the Professor of Emerging Infectious Diseases and Global Health at Oxford University, as well as the Chief Investigator of the trial. “We have already discovered that one treatment, dexamethasone, benefits Covid-19 patients, but the death rate remains too high, so we must keep searching for others,” he said.

“The Recovery trial was specifically designed so that when promising investigational drugs such as REGN-COV2 became available they can be tested quickly,” he continued. “We must confirm REGN-COV2 is safe and effective in the context of a large-scale randomised clinical trial; the only way to be certain it works as a treatment for Covid-19.”

Martin Landray, the Deputy Chief Investigator of the trial and Professor of Medicine and Epidemiology said: “We’ve been studying whether existing drugs can be re-purposed, but we now have the opportunity to assess the impact of a drug specifically designed to target coronavirus.”

He went on to say: “There are good reasons to be excited about this new development – Recovery will provide a robust assessment of the effect of this lab-manufactured monoclonal antibody combination treatment in hospitalised patients.”

Deputy Chief Medical Officer Jonathan Van Tam said that the Recovery trial was globally recognised as the most successful in the world:

“Today’s news is another promising step in the search to find effective treatments, which will improve our ability to deal with this destructive virus,” he said, “and a testament to the confidence that others around the world have in this brilliantly conceived and executed trial.”

However, while dexamethasone is an old drug and well out of patent, and costs around £5 to treat a patient, there will be a lot of questions over the affordability of the new antibody cocktail—if it works.

“Novel antivirals and monoclonal antibodies are among the most exciting and promising treatments for Covid-19 because they are specific to the disease, but they are also traditionally the most expensive,” said Nick Cammack, Covid-19 Therapeutics Accelerator Lead at Wellcome.

“Large-scale randomised controlled studies like Recovery give us the best understanding of whether drugs like REGN-COV2 are safe and effective against Covid-19,” he said, “but we must ensure that any successful treatment is available to everyone who needs it globally.”

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