Chris Christie has recovered after testing positive for Covid-19 (AP Images)

Covid-19 roundup: Can Ab­b­Vie’s dis­ap­point­ing NASH drug ceni­crivi­roc find suc­cess fight­ing cy­tokine storms?; Trump al­ly Chris Christie says he re­ceived Lil­ly's an­ti­body cock­tail

Af­ter get­ting passed down the line to Ab­b­Vie through a cou­ple of biotech buy­outs, the phar­ma gi­ant is now in line to see if their drug ceni­crivi­roc can score a suc­cess in the glob­al war against Covid-19.

The NIH has se­lect­ed this drug — which has proven un­der­whelm­ing as a NASH-tar­get­ed ther­a­py — as one of 3 it will test in a new adap­tive study dubbed AC­TIV-1 Im­mune Mod­u­la­tors, which is look­ing for new ways to fight off the cy­tokine storms that kill some pa­tients.

The oth­er 2 drugs se­lect­ed from among 130 can­di­dates are the high pro­file im­mune mod­u­la­tors Rem­i­cade and Oren­cia. So far re­pur­pos­ing ex­ist­ing drugs for the virus has of­ten proved frus­trat­ing­ly dis­ap­point­ing. But no­body’s aban­doned that ap­proach yet. Armed with BAR­DA cash, in­ves­ti­ga­tors at the NIH say these 3 have pro­files in­di­cat­ing their po­ten­tial in com­bat­ing one of the most threat­en­ing as­pects of Covid-19. There’s al­so enough drug avail­able to add an ex­tra study.

All pa­tients en­rolled in the study will get remde­sivir, now un­der a cloud af­ter a new WHO study con­clud­ed it pro­vides no ev­i­dent ben­e­fit to pa­tients, as well as con­va­les­cent plas­ma and dex­am­etha­sone — if the doc­tors in­volved be­lieve it will help.

Why ceni­crivi­roc?

The late-stage drug has pro­vid­ed un­der­whelm­ing ev­i­dence of ef­fi­ca­cy in NASH — like most every­thing else thrown against NASH — af­ter Brent Saun­ders picked it up at Al­ler­gan in the $1.7 bil­lion To­bi­ra buy­out. Ab­b­Vie in­her­it­ed the pro­gram with the rest of the Al­ler­gan pipeline fol­low­ing its own buy­out.

The drug is a dual-re­cep­tor an­tag­o­nist, tar­get­ing CCR2 and CCR5, which pro­vides a ra­tio­nale that it can help the worst off pa­tients ad­mit­ted to the hos­pi­tal.

This isn’t the on­ly adap­tive tri­al ex­am­in­ing how this drug per­forms against Covid-19. It was al­so tapped along­side Ote­zla and Fi­razyr for I-SPY COVID back in Au­gust, where re­searchers are look­ing for ways to fight acute res­pi­ra­to­ry dis­tress syn­drome.

An­oth­er pos­si­ble rem­e­dy for cy­tokine storm has been pre­sent­ed by the an­ti-GM-CSF class of drugs, where Hu­mani­gen and GSK, among oth­ers, are test­ing drugs that have po­ten­tial specif­i­cal­ly to fight back against the most se­vere im­mune re­ac­tions. For Hu­mani­gen, the pan­dem­ic has of­fered a vir­tu­al re­birth for the com­pa­ny, af­ter watch­ing its shares trade OTC for some time.

Hu­mani­gen’s drug lenzilum­ab was cho­sen for an­oth­er NIH study on Covid-19 ear­li­er, which al­so added the IL-23 drug Skyrizi (risankizum­ab) from Ab­b­Vie and Boehringer In­gel­heim. — John Car­roll

Chi­na push­es ex­per­i­men­tal vac­cines out­side tri­als

Sino­vac and Chi­na Na­tion­al Biotec Group may not be test­ing their Covid-19 vac­cines, but the com­pa­nies are al­ready ex­pand­ing its reach to the Chi­nese pop­u­la­tion through emer­gency use pro­vi­sions.

As well as spawn­ing a light­ning-speed vac­cine de­vel­op­ment pro­gram, the pan­dem­ic has trig­gered an un­prece­dent­ed vac­ci­na­tion cam­paign in Chi­na, where at least 350,000 peo­ple are re­port­ed to have re­ceived an in­oc­u­la­tion out­side of clin­i­cal tri­als. Since the vac­cines re­main un­proven, ex­perts have cau­tioned that it could pro­vide a false sense of se­cu­ri­ty or worse, lead­ing to surges in side ef­fects that are not prop­er­ly mon­i­tored.

Ji­ax­ing, a city lo­cat­ed just south of Shang­hai with a pop­u­la­tion of over 3 mil­lion, is of­fer­ing Sino­vac’s ex­per­i­men­tal vac­cine to high-risk groups and res­i­dents who have “emer­gency needs.” The price, lo­cal me­dia re­port­ed, is RMB$200 ($29.87) per shot for a two-dose reg­i­men.

Chi­na Na­tion­al Biotec Group, on the oth­er hand, is of­fer­ing its jabs (it’s de­vel­op­ing two) for free to stu­dents who are study­ing abroad — much as it gave ac­cess to over­seas work­ers of state-owned en­ter­pris­es and med­ical work­ers with­in the coun­try.

More than 168,000 peo­ple had signed up for the pro­gram on­line and over 91,000 are be­ing con­sid­ered, AP re­port­ed, cit­ing a no­tice on CN­BG’s web­site that’s since been re­moved.

In com­par­i­son, its Phase III tri­als are en­rolling a to­tal of 40,000 vol­un­teers across the Unit­ed Arab Emi­rates, Bahrain, Pe­ru and Mo­roc­co. Sino­vac, which is con­duct­ing tri­als in Brazil and In­done­sia, among oth­ers, is en­rolling sim­i­lar num­bers. — Am­ber Tong

Trump al­ly Chris Christie says he re­ceived Lil­ly’s an­ti­body cock­tail

When he was hos­pi­tal­ized for Covid-19, Pres­i­dent Don­ald Trump said he asked for Re­gen­eron’s ex­per­i­men­tal an­ti­body cock­tail — and re­ceived it. And now one of his long­time al­lies re­vealed he’s re­ceived a ri­val an­ti­body treat­ment from Eli Lil­ly.

Chris Christie, the for­mer gov­er­nor of New Jer­sey, was be­lieved to have been in­fect­ed at the Rose Gar­den cer­e­mo­ny that An­tho­ny Fau­ci has called a su­per-spread­er event. Hav­ing re­cov­ered from the in­fec­tion — af­ter 7 days in in­ten­sive care — he thanked his doc­tors and “the man­u­fac­tur­ers of Remde­sivir and the Eli Lil­ly mon­o­clon­al an­ti-body cock­tail for giv­ing me ac­cess to their ex­tra­or­di­nary treat­ments.”

Trump, who was al­so giv­en remde­sivir, had since lav­ished praise on both Re­gen­eron’s and Eli Lil­ly’s drugs, promis­ing to au­tho­rize them quick­ly and make them avail­able for free to the Amer­i­can pub­lic.

Both Trump and Christie had se­cured ac­cess through com­pas­sion­ate use re­quests, some­thing bio­phar­ma com­pa­nies don’t typ­i­cal­ly like and are not oblig­ed to com­ply.

As the drugs are still be­ing test­ed in clin­i­cal tri­als and not yet wide­ly avail­able — Re­gen­eron has 50,000 dos­es cur­rent­ly while Lil­ly ex­pects to have 100,000 some time in Oc­to­ber — bioethi­cists and watch­dogs have ques­tioned the ethics be­hind giv­ing Trump spe­cial ac­cess.

“When it’s the pres­i­dent of the Unit­ed States, of course, that gets — ob­vi­ous­ly — gets our at­ten­tion,” Re­gen­eron CEO Len Schleifer had told Katie Thomas at the New York Times.

With Christie, how­ev­er, the stakes ap­pear dif­fer­ent. It is not im­me­di­ate­ly clear what stan­dards Lil­ly ap­plied in grant­i­ng his re­quest.

Lil­ly’s pro­gram is un­der a cloud of un­cer­tain­ty af­ter the NIH halt­ed a tri­al test­ing its an­ti­body, which was co-de­vel­oped with Ab­Cellera, over a safe­ty con­cern — while FDA in­spec­tors took is­sue with qual­i­ty con­trol at a man­u­fac­tur­ing plant. — Am­ber Tong

First au­tho­rized vac­cines may be met with re­luc­tant Amer­i­cans, poll sug­gests

About 70% of reg­is­tered vot­ers sur­veyed said they would take a Covid-19 vac­cine, al­though many want to wait un­til it has been avail­able for a while to see if there are ma­jor prob­lems or side ef­fects, a new Wall Street Jour­nal/NBC News poll shows.

The sur­vey found that 20% of re­spon­dents said they would take a vac­cine as soon as one be­comes avail­able, while about half the re­spon­dents want­ed to wait un­til they learned more in­for­ma­tion about the shot.

The lat­est re­sults echo ear­li­er sen­ti­ments amid a cam­paign to de­vel­op im­mu­niza­tions at un­prece­dent­ed speed and come af­ter ac­cu­sa­tions of politi­ciza­tion from all sides. Crit­ics have lam­bast­ed Pres­i­dent Don­ald Trump’s pub­lic promise to de­liv­er a vac­cine by Elec­tion Day and sound­ed alarm on the pres­sure he ap­pears to be push­ing on FDA com­mis­sion­er Stephen Hahn — while Trump has sug­gest­ed with­out ev­i­dence that there’s a “deep state” work­ing in­side the agency to de­lay a vac­cine au­tho­riza­tion. — Am­ber Tong

For a look at all End­points News coro­n­avirus sto­ries, check out our spe­cial news chan­nel.

ZS Per­spec­tive: 3 Pre­dic­tions on the Fu­ture of Cell & Gene Ther­a­pies

The field of cell and gene therapies (C&GTs) has seen a renaissance, with first generation commercial therapies such as Kymriah, Yescarta, and Luxturna laying the groundwork for an incoming wave of potentially transformative C&GTs that aim to address diverse disease areas. With this renaissance comes several potential opportunities, of which we discuss three predictions below.

Allogenic Natural Killer (NK) Cells have the potential to displace current Cell Therapies in oncology if proven durable.

Despite being early in development, Allogenic NKs are proving to be an attractive new treatment paradigm in oncology. The question of durability of response with allogenic therapies is still an unknown. Fate Therapeutics’ recent phase 1 data for FT516 showed relatively quicker relapses vs already approved autologous CAR-Ts. However, other manufacturers, like Allogene for their allogenic CAR-T therapy ALLO-501A, are exploring novel lymphodepletion approaches to improve persistence of allogenic cells. Nevertheless, allogenic NKs demonstrate a strong value proposition relative to their T cell counterparts due to comparable response rates (so far) combined with the added advantage of a significantly safer AE profile. Specifically, little to no risk of graft versus host disease (GvHD), cytotoxic release syndrome (CRS), and neurotoxicity (NT) have been seen so far with allogenic NK cells (Fig. 1). In addition, being able to harness an allogenic cell source gives way to operational advantages as “off-the-shelf” products provide improved turnaround time (TAT), scalability, and potentially reduced cost. NKs are currently in development for a variety of overlapping hematological indications with chimeric antigen receptor T cells (CAR-Ts) today, and the question remains to what extent they will disrupt the current cell therapy landscape. Click for more details.

What lured Hal Bar­ron away?; Top FDA minds on ac­cel­er­at­ed ap­proval re­forms; ‘Dead wrong’ Aduhelm ad blitz; and more

Welcome back to Endpoints Weekly, your review of the week’s top biopharma headlines. Want this in your inbox every Saturday morning? Current Endpoints readers can visit their reader profile to add Endpoints Weekly. New to Endpoints? Sign up here.

Nothing can really compete with Hal Barron’s departure from GlaxoSmithKline as the news of the week, but we do have plenty of original reporting and analysis from the Endpoints team in this edition. Enjoy and have a nice weekend.

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Covid-19 roundup: HHS may strug­gle to ab­sorb Op­er­a­tion Warp Speed; Eu­rope has no plans for a fourth vac­cine dose

Operation Warp Speed, perhaps the greatest achievement of the former Trump administration, promptly delivered Covid-19 vaccine supplies nationwide when they became available, thanks to collaborations between HHS and the Department of Defense, while helping to fund and aid the manufacture of billions of doses.

But since the Biden administration took over a year ago, acting FDA commissioner Janet Woodcock transitioned out of her role as the therapeutics lead in Warp Speed, which has been converted into a new operation without the fancy name (now known as the “HHS-DOD COVID-19 Countermeasures Acceleration Group”), and as of the start of 2022, the Department of Defense is no longer helping HHS on the program.

Mer­ck wins le­gal bat­tle over in­sur­ance cov­er­age af­ter ran­somware at­tack

Merck has emerged victorious from a years-long legal battle with insurers over the coverage of more than a billion dollars in losses from the malware NotPetya, with a New Jersey Superior Court judge concluding that the responsibility is on insurers to clarify their policies around cyber attacks.

The pharma giant was one of several victims of a global cyber attack back in 2017 that also hit Danish shipping company Maersk, American food company Mondelēz, French construction giant Saint-Gobain and even the systems monitoring the Chernobyl nuclear power stations, Bloomberg reported back in 2019.

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Crit­ics push back on Alzheimer’s As­so­ci­a­tion ad blitz to get Medicare to change its Aduhelm rul­ing: 'Dead wrong'

The latest Alzheimer’s Association advertising campaign encourages people to fight.

Not against the disease or for more research or treatments, but against the Centers for Medicare and Medicaid Services. More specifically, CMS’ recent reimbursement decision to only pay for Biogen and Eisai’s controversial Alzheimer’s drug Aduhelm for patients in clinical trials.

With CMS’ preliminary decision now in a 30-day comment period, patient advocates’ goal is to convince CMS to reverse its decision with a marketing blitz and public pressure.

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Dan O'Day, Gilead CEO (Jim Watson/AFP via Getty Images)

Fail­ing to con­firm clin­i­cal ben­e­fit, Gilead pulls 2 ac­cel­er­at­ed ap­proval in­di­ca­tions for can­cer drug

Gilead recently decided to pull two indications for its cancer drug Zydelig — in relapsed follicular B-cell non-Hodgkin lymphoma (FL) and relapsed small lymphocytic leukemia (SLL) — after failing to complete the confirmatory trials required as part of the accelerated approvals from 2014.

“As the treatment landscape for FL and SLL has evolved, enrollment into the confirmatory study has been an ongoing challenge,” Gilead said in a statement, noting it formally notified the FDA of its decision to voluntarily withdraw these indications.

Hal Barron, Endpoints UKBIO20 (Jeff Rumans)

'Al­tos was re­al­ly a once-in-a-life­time op­por­tu­ni­ty': Hal Bar­ron re­flects on his big move

By all accounts, Hal Barron had one of the best jobs in Big Pharma R&D. He made more than $11 million in 2020, once again reaping more than his boss, Emma Walmsley, who always championed him at every opportunity. And he oversaw a global R&D effort that struck a variety of big-dollar deals for oncology, neurodegeneration and more.

Sure, the critics never let up about what they saw as a rather uninspiring late-stage pipeline, where the rubber hits the road in the Big Pharma world’s hunt for the next big near-term blockbuster, but the in-house reviews were stellar. And Barron was firmly focused on bringing up the success rate in clinical trials, holding out for the big rewards of moving the dial from an average 10% success rate to 20%.

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Executive Director of the EMA Emer Cooke (AP Photo/Geert Vanden Wijngaert)

Eu­ro­pean Par­lia­ment signs off on strength­en­ing drug reg­u­la­tor's abil­i­ty to tack­le short­ages

The European Parliament on Thursday endorsed a plan to increase the powers of the European Medicines Agency, which will be better equipped to monitor and mitigate shortages of drugs and medical devices.

By a vote of 655 to 31, parliament signed off on a provisional agreement reached with the European Council from last October, in which the EMA will create two shortage steering groups (one for drugs, the other for devices), a new European Shortages Monitoring Platform to facilitate data collection and increase transparency, and on funding for the work of the steering groups, task force, working parties and expert panels that are to be established.

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FDA+ roundup: FDA's neu­ro­science deputy de­parts amid on­go­ing Aduhelm in­ves­ti­ga­tions; Califf on the ropes?

Amid increased scrutiny into the close ties between FDA and Biogen prior to the controversial accelerated approval of Aduhelm, the deputy director of the FDA’s office of neuroscience has called it quits after more than two decades at the agency.

Eric Bastings will now take over as VP of development strategy at Ionis Pharmaceuticals, the company said Wednesday, where he will provide senior clinical and regulatory leadership in support of Ionis’ pipeline.

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