Regeneron’s Antibody Drug Cuts Risk of Death in Some Covid-19 Patients

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An antibody treatment developed by

Regeneron Pharmaceuticals Inc.

REGN 0.67%

has been shown to significantly cut the risk of death among certain hospitalized Covid-19 patients, raising hopes for a valuable new tool for tackling severe cases.

A large U.K. trial involving nearly 10,000 patients showed that administering REGEN-COV on top of usual care reduced the risk of dying by a fifth among hospitalized coronavirus patients who hadn’t produced antibodies to the virus. The drug had no effect among patients who had already produced antibodies.

The results released Wednesday by the U.K. researchers are a boost for a drug class that until now had only been shown to work against milder forms of the disease. Antibody therapies for Covid-19 target the spike protein on the surface of the virus with the aim of preventing it from entering cells. Earlier trials of other antibody therapies in hospitalized patients were stopped because the treatments appeared to be ineffective in these severe cases.

“This is in some ways a first,” said Martin Landray, professor of medicine and epidemiology at the University of Oxford and one of the study’s leaders. “These patients are among the sickest patients, and we have a treatment we didn’t have before.” The study is part of the U.K’s wider RECOVERY trial, which tests various drugs against Covid-19.

In the trial, REGEN-COV was used on top of dexamethasone, a steroid treatment which was shown last year to reduce the risk of dying by 17% in all hospitalized patients. “Now you’re layering the effect of steroids,” said

George Yancopoulos,

Regeneron’s president and chief scientific officer. “That’s what makes it exciting.”

Of the 9,785 participants involved in the REGEN-COV study, around a third didn’t have antibodies in their blood when they entered the trial. Some people’s immune systems don’t produce antibodies or are slow to do so for a variety of reasons, including underlying health conditions or as a result of treatments like chemotherapy, according to the investigators. These were the patients who benefited from treatment with REGEN-COV, a cocktail of two antibodies that each targets different parts of the spike protein.

How Monoclonal Antibody Therapy Works

When patients are infected by the new coronavirus, their immune systems should produce antibodies that bind to the virus and prevent it from spreading throughout the body.

Antibodies block a spike protein on the virus’s surface that normally helps the virus latch onto and infect cells.

But some people don’t mount an effective immune response. For them, researchers are developing treatments based on antibodies derived from patients who’ve already recovered from Covid-19. Sick patients receive an infusion of the antibodies in hopes of fighting the infection.

Manufacturing the Antibodies

Donor who had coronavirus

2. In the lab, the B cells are mixed with spike proteins derived from coronavirus

1. From a recovered patient’s blood, researchers isolate B cells, immune cells that make antibodies

Cells implanted

with genes

5. The genes are placed inside cells and grown in bioreactors to produce antibodies in an assembly line fashion

4. Once scientists identify the B cells that most strongly bind to the spike proteins, they isolate the genes inside the cells that produce antibodies

3. B cells latch onto the spike proteins that are most likely to neutralize the virus

6. These highly specific antibodies are concentrated into a liquid solution, poured into vials, and injected into sick Covid-19 patients.

Patient

who has

coronavirus

When patients are infected by the new coronavirus, their immune systems should produce antibodies that bind to the virus and prevent it from spreading throughout the body.

Antibodies block a spike protein on the virus’s surface that normally helps the virus latch onto and infect cells.

But some people don’t mount an effective immune response. For them, researchers are developing treatments based on antibodies derived from patients who’ve already recovered from Covid-19. Sick patients receive an infusion of the antibodies in hopes of fighting the infection.

Manufacturing the Antibodies

Donor who had coronavirus

2. In the lab, the B cells are mixed with spike proteins derived from coronavirus

1. From a recovered patient’s blood, researchers isolate B cells, immune cells that make antibodies

Cells implanted

with genes

5. The genes are placed inside cells and grown in bioreactors to produce antibodies in an assembly line fashion

3. B cells latch onto the spike proteins that are most likely to neutralize the virus

4. Once scientists identify the B cells that most strongly bind to the spike proteins, they isolate the genes inside the cells that produce antibodies

6. These highly specific antibodies are concentrated into a liquid solution, poured into vials, and injected into sick Covid-19 patients.

Patient

who has

coronavirus

When patients are infected by the new coronavirus, their immune systems should produce antibodies that bind to the virus and prevent it from spreading throughout the body.

Antibodies block a spike protein on the virus’s surface that normally helps the virus latch onto and infect cells.

But some people don’t mount an effective immune response. For them, researchers are developing treatments based on antibodies derived from patients who’ve already recovered from Covid-19. Sick patients receive an infusion of the antibodies in hopes of fighting the infection.

Manufacturing the Antibodies

Donor who had coronavirus

2. In the lab, the B cells are mixed with spike proteins derived from coronavirus

1. From a recovered patient’s blood, researchers isolate B cells, immune cells that make antibodies

Cells implanted

with genes

5. The genes are placed inside cells and grown in bioreactors to produce antibodies in an assembly line fashion

3. B cells latch onto the spike proteins that are most likely to neutralize the virus

4. Once scientists identify the B cells that most strongly bind to the spike proteins, they isolate the genes inside the cells that produce antibodies

6. These highly specific antibodies are concentrated into a liquid solution, poured into vials, and injected into sick Covid-19 patients.

Patient

who has

coronavirus

When patients are infected by the new coronavirus, their immune systems should produce antibodies that bind to the virus and prevent it from spreading through the body.

Antibodies block a spike protein on the virus’s surface that normally helps the virus latch onto and infect cells.

But some people don’t mount an effective immune response. For them, researchers are developing treatments based on antibodies derived from patients who’ve already recovered from Covid-19. Sick patients receive an infusion of the antibodies in hopes of fighting the infection.

Manufacturing the Antibodies

Donor

who had coronavirus

1. From a recovered patient’s blood, researchers isolate B cells, immune cells that make antibodies

2. In the lab, the B cells are mixed with spike proteins derived from coronavirus

3. B cells latch onto the spike proteins that are most likely to

neutralize

the virus

4. Once scientists identify the B cells that most strongly bind to the spike proteins, they isolate the genes inside the cells that produce antibodies

Cells implanted

with genes

5. The genes are placed inside cells and grown in bioreactors to produce antibodies in an assembly line

fashion

6. These highly specific antibodies are concentrated into a liquid solution, poured into vials, and injected into sick Covid-19 patients.

Patient

who has

coronavirus

Several drugmakers are developing these types of drugs, with mixed success. Some have been granted emergency-use authorization from the U.S. Food and Drug Administration for mild to moderate disease. But there have also been setbacks. On Tuesday,

AstraZeneca

PLC said its antibody therapy failed to prevent symptomatic Covid-19 in people recently exposed to the virus.

Regeneron said it would seek emergency-use authorization from the FDA for REGEN-COV among hospitalized patients. The drug has been available to treat recently diagnosed Covid-19 since November, and Regeneron has so far struck deals with the U.S. government to supply more than 1.5 million doses. In clinical trials, the drug reduced the risk of hospitalization or death by 70% in people with mild to moderate symptoms.

U.K. Prime Minister Boris Johnson announced a four-week extension to the country’s Covid-19 restrictions Monday as the country deals with an increase in Delta variant infections. WSJ’s Jason Douglas explains what that could mean for the global effort to contain the virus. Photo: Henry Nicholls/Reuters

Write to Denise Roland at Denise.Roland@wsj.com

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