COVID-19 drugs that work

[island911]

putting disinfecting UV light into the lungs? Yikes!

[jyl]

Originally Posted by island911

putting disinfecting UV light into the lungs? Yikes!

Please don’t bother me, I am trying to inhale a heat lamp.

[Aurel]

WHO says there is no evidence that recovering from COVID-19 gives immunity. Very bad news if that is the case, because how could there be a vaccine if the antibodies don’t even give immunity?

https://www.france24.com/en/20200425-no-evidence-that-recovering-from-covid-19-gives-people-immunity-who-says

[cabmandone]

Originally Posted by Aurel

WHO says there is no evidence that recovering from COVID-19 gives immunity. Very bad news if that is the case, because how could there be a vaccine if the antibodies don’t even give immunity?

https://www.france24.com/en/20200425-no-evidence-that-recovering-from-covid-19-gives-people-immunity-who-says

Let's not forget this is the same group that said there were no person to person transmissions early on... I'll wait until a consensus is formed. I think what they're trying to do is tamp down any over exuberance on the part of people wanting to group together too soon.

[jyl]

No evidence of X is not the same as evidence of not X.

Don’t read too much into WHO’s statement.

[RWebb]

it is unsurprising that a previous infection with this type of virus gives little to no immunity

high mutability is a thing

[jyl]

https://www.statnews.com/2020/04/27/arthritis-drug-kevzara-disappoints-as-coronavirus-treatment/

Bad news for IL6 inhibitor Kevaza (trial stopped for futility, only slight signal of efficacy is in very severes).

"CNBC noted that Regeneron and Sanofi announced on Monday that their rheumatoid arthritis drug, Kevzara, showed promise for treating the sickest coronavirus patients in a clinical trial but was not beneficial for patients with less-advanced disease. The companies said they would stop testing the drug in that group, which featured patients characterized as "severe," those requiring low levels of supplemental oxygen and who were not on ventilators. Sicker patients characterized as "critical," those requiring mechanical ventilation, high-flow oxygen or treatment in intensive care, did show a benefit from Kevzara compared with a placebo. The companies are proceeding with a larger trial of this group and results are expected by June." The benefit for the sickest pts was modest, about 10% benefited.

This is pretty disappointing, after

https://www.aphp.fr/contenu/le-tocilizumab-ameliore-significativement-le-pronostic-des-patients-avec-pneumonie-covid

which was apparently good news for IL6 inhibitor Actemra (although this is a smaller and open label trial, and no details were given).

[Steve Carlton]

Originally Posted by jyl

Please don’t bother me, I am trying to inhale a heat lamp.

Every time I visit this thread, this makes me laugh.

[icemann427]

https://www.msn.com/en-us/news/world/in-race-for-a-coronavirus-vaccine-an-oxford-group-leaps-ahead/ar-BB13hkGt?li=BBnb7Kz

[Tobra]

UV light has been tried for other pulmonary infections, seem to recall it was no bueno, so they switch to laser light.

Successful virus does not kill the host, too virulent and it does not spread. Winning is making more virus, so dead host is losing.

[Steve Carlton]

You're talking millions of years of evolution. The virus doesn't make any choices.

[jyl]

NIAD trial of remedsivir in moderate and severe pts met endpoint (succeeded in showing benefit). Fauci gave a little more: improved time to clinical improvement, reduced mortality. This was a real placebo controlled trial. Details to come.

This, plus the little bit of info from GILD’s own trial and the aborted Chinese trials, and what we know about supply and mode of administration, strongly suggest:

- the drug has a real, proven benefit
- the benefit is moderate rather than huge, though could be larger if dosed earlier
- drug will be in very short supply for rest of 2020 at least
- for at least 2020, only genuine GILD-made drug is likely to be trustworthy, we’ve already seen that Chinese copy drug is unreliable
- while it likely has most benefit if dosed early, good chance it gets reserved for pts who progress to more advanced disease - unless you are a VIP
- from a macro POV, it probably reduces need for ventilation and reduces mortality, rather than really reducing need for hospital beds

I would expect this drug to be approved in the next 30 days.

Next to watch, for the existing drugs being tested, is Actemra. Even though Kevaza failed, and they are both IL-6 inhibitors, the early Actemra data still gives some hope. This will be a drug for severe cases, if it works.

We’ve not yet seen a drug that works for milder cases, or a drug that works and is in ample supply.

Attention probably turns now to vaccine progress. I’m unimpressed by success in monkey models. Human trials are underway/about to start for several candidates. I still think pretty good chance of one or more fairly effective vaccines by early/mid 2021, in enough supply that frontline HCW and the most vulnerable ppl in rich countries can get it. If you’re in India or Brazil, sorry.

[tadd]

https://www.youtube.com/watch?v=yvBiU3rD6uc

You know that something is good if they are willing to let the placebo group know so they can take it.

[Tobra]

Tadd, that is fairly typical in studies such as this.

From what I read, the remedsivir group vs placebo were 8% fatality vs 11%, or something like that.

I wonder if that is statistically significant.

[tadd]

Tobra:
Well, when it’s 10-15% survival If you go on a vent, 3% is something.

Now there is a place for the chemists to start...look at the huge changes in the effectiveness and toxicity of fentanyl and its derritives just by swapping a few functional groups.

Fentanyl has a 2 carbon chain attaching the benzene ring. Shrink that to 1 and the activity drops by a factor of 100. The substitution making carfentanyl jacks that to +1000X.

[Tobra]

The survival rate for all patients who go on a vent is essentially the same as the survival rate of CCP virus victims that go on a vent. Both are about 20%.

[jyl]

Originally Posted by Tobra

Tadd, that is fairly typical in studies such as this.

From what I read, the remedsivir group vs placebo were 8% fatality vs 11%, or something like that.

I wonder if that is statistically significant.

The mortality benefit was not quite stat sig, something like p = 0.058.

The shorter hospitalization benefit was definitely stat sig.

[island911]

Originally Posted by tadd

https://www.youtube.com/watch?v=yvBiU3rD6uc

You know that something is good if they are willing to let the placebo group know so they can take it.

Yep. I've known about this anti-viral for months; and posted about it 6 weeks ago. FINALLY it is Uuge news.

Can we get others back to work now? sheesh.

[pmax]

Originally Posted by island911

Yep. I've known about this anti-viral for months; and posted about it 6 weeks ago. FINALLY it is Uuge news.

Can we get others back to work now? sheesh.

I said it right here.

http://forums.pelicanparts.com/off-topic-discussions/1056912-covid-19-drugs-work.html#post10820410

[Chocaholic]

Originally Posted by jyl

The mortality benefit was not quite stat sig, something like p = 0.058.

The shorter hospitalization benefit was definitely stat sig.

Stat sig. cool buzz words. And used it twice.