Af­ter a slew of fail­ures, the NIH’s AC­TIV-3 tri­al for hos­pi­tal­ized Covid-19 pa­tients has earned its rep­u­ta­tion as a grave­yard for big-name an­ti­bod­ies. Now, with its op­tions run­ning out, the NIH is turn­ing to a No­var­tis-backed an­ti­body al­ter­na­tive — but is this déjà vu all over again?

Mol­e­c­u­lar Part­ners and part­ner No­var­tis will try out their “trispe­cif­ic” DARPin an­tivi­ral enso­vibep in AC­TIV-3, the hos­pi­tal­ized mild-to-mod­er­ate pa­tient arm of the NIH’s AC­TIV “mas­ter pro­to­col” against Covid-19, the pair said Mon­day.

The mol­e­cule is one of a nov­el class of ther­a­peu­tics de­vel­oped by Mol­e­c­u­lar Part­ners that aims to per­form the same func­tions as an­ti­bod­ies with far more tar­get speci­fici­ty and an­tivi­ral pro­tec­tion. The drug­mak­er is per­haps best known for its mac­u­lar de­gen­er­a­tion DARPin pact with Ab­b­Vie, which the FDA hit with a CRL back in June.

But now, with No­var­tis on board to help its piv­ot to­ward Covid-19, Mol­e­c­u­lar Part­ners thinks it has the win­ning ear­ly-stage da­ta to suc­ceed where big drug­mak­ers haven’t in AC­TIV-3, which has proven to be a waste­land for an­ti­bod­ies. Enso­vibep, pre­vi­ous­ly known as MP0420, is one of two mol­e­cules at the cen­ter of a $231 mil­lion deal with No­var­tis signed in Oc­to­ber and de­signed to chart a new path at Covid-19 ther­a­peu­tics.

“What we know from the pre­clin­i­cal da­ta is we ac­tu­al­ly get in­to the lungs very fast, we block the virus very fast so there is no in­fec­tiv­i­ty, no ac­tiv­i­ty, and we don’t clear as fast as the an­ti­bod­ies,” CEO Patrick Am­stutz told End­points News. Mol­e­c­u­lar Part­ners al­so ar­gues that its high-affin­i­ty DARPins bind much bet­ter to the SARS-Cov-2 spike pro­tein than an­ti­bod­ies with­out spurring im­mune side ef­fects.

But it’s still not a sure thing, Am­stutz said.

“If those dif­fer­ences will lead to ac­tiv­i­ty in this set­ting, we just don’t know,” he said. “I would say the prob­a­bil­i­ty of suc­cess is high­er than an an­ti­body, but it’s still a rough tri­al. In this sit­u­a­tion, we have to try — there is ra­tio­nale to be­lieve, (but) the bar is very high.”

AC­TIV-3 will ini­tial­ly ran­dom­ize 300 hos­pi­tal­ized pa­tients with mild-to-mod­er­ate Covid-19 who have ex­pe­ri­enced less than 13 days of symp­toms on enso­vibep and place­bo on top of stan­dard of care. Five days af­ter dos­ing, pa­tients’ con­di­tion will be as­sessed on the need for sup­ple­men­tal oxy­gen, me­chan­i­cal ven­ti­la­tion, or oth­er sup­port­ive care. If enso­vibep shows promise at that ear­ly check in, the NIH will en­roll an ad­di­tion­al 700 pa­tients, who will be fol­lowed for 90 days with a pri­ma­ry end­point of sus­tained re­cov­ery over stan­dard of care 14 days af­ter leav­ing the hos­pi­tal.

Ear­li­er this month, Glax­o­SmithK­line and Vir Biotech­nol­o­gy closed en­roll­ment for their part­nered an­ti­body VIR-7831 in AC­TIV-3 tri­al af­ter the drug showed neg­li­gi­ble ef­fect in achiev­ing sus­tained re­cov­ery in hos­pi­tal­ized Covid-19 pa­tients. At a pre­de­ter­mined 300-pa­tient in­ter­im check-in, an in­de­pen­dent da­ta com­mit­tee “raised con­cerns about the mag­ni­tude of po­ten­tial ben­e­fit” for the an­ti­body and de­cid­ed to halt en­roll­ment as the da­ta “ma­ture.’

Just days lat­er, the NIH shut down en­roll­ment for Brii Bio­sciences’ two an­ti­bod­ies in the study. Eli Lil­ly and its an­ti­body LY-CoV555 were boot­ed from the study way back in Oc­to­ber with the drug­mak­er cit­ing study de­sign is­sues — in­clud­ing the tall task of prov­ing ben­e­fit on top of Gilead’s remde­sivir — as a po­ten­tial bar­ri­er to suc­cess.

Those fail­ures may have paved the way for the NIH to give enso­vibep a try de­spite its rel­a­tive­ly un­known clin­i­cal pro­file. Tak­ing a shot at a high-pro­file study and suc­ceed­ing would be a big boost for Mol­e­c­u­lar Part­ners’ pro­file, but Am­stutz is still man­ag­ing ex­pec­ta­tions.

“For us, we’re bring­ing the first non-an­ti­body to the tri­al, and that’s al­ready an achieve­ment for us,” he said. “I know what you know: All an­ti­bod­ies have failed. As a sci­en­tist, you can’t run the same ex­per­i­ment in the same set­ting and ex­pect dif­fer­ent re­sults. That’s not what we do so you need to change some­thing.”

Due to the high bar for suc­cess, Mol­e­c­u­lar Part­ners is hold­ing out more hope for enso­vibep in its oth­er clin­i­cal tri­als, which in­cludes a Phase II study fo­cused on in­fec­tiv­i­ty and Phase II/III test, dubbed EM­PA­THY, for mild-to-mod­er­ate pa­tients in the out­pa­tient set­ting. The part­ners hope to be­gin­ning en­rolling that study, which will in­clude 2,400 pa­tients, in ear­ly 2021 with eyes on a po­ten­tial emer­gency use au­tho­riza­tion with­in the year.

Else­where, Mol­e­c­u­lar Part­ners is try­ing in­tra­venous enso­vibep in a Phase I safe­ty and dose es­ca­la­tion tri­al. Ear­ly re­sults from that study showed the ther­a­py had a two- to three-week half-life in pa­tients with no se­ri­ous side ef­fects.

Biotech is one of the smartest, best educated industries on the planet. PhDs abound. We’ve had a long enough track record to see a new generation of savvy, experienced execs coming together to run startups.

And in these times, they are being tested as never before.

Biotech is going through quite a rough patch right now. For 2 years, practically anyone with a decent resume and some half-baked ideas on biotech could start a company and get it funded. The pandemic made it easy in many ways to pull off an IPO, with traditional road shows shut down in exchange for a series of quick Zoom meetings. Generalist investors flocked as the numbers raised soared into the stratosphere.

It looks like Warren Buffett is sticking to ice cream and railroads for the moment.

The billionaire CEO of Berkshire Hathaway backed out of two major holdings in the pharma industry, Forexlive first reported, including a $410 million investment in AbbVie and a $324.4 million stake in Bristol Myers Squibb.

The move comes after Berkshire abandoned its Teva shares just last quarter, Bloomberg reported.

Nearly a year ago, more than 200 workers at Novartis’ Grimsby, UK, facility were able to hang on to their jobs after the pharma closed a Switzerland site as a part of its workforce restructuring plan. Now, it looks like those employees’ time is up, as the site has been sold, Grimsby Telegraph reported today.

The manufacturing site has been sold to Humber Industrials, a subsidiary of International Process Plants. None of the current staff members will be working with the new owners, however.

The latest wave of the pandemic — marked by Omicron and its sub-variants — has seen higher hospitalization rates for young children, health agencies have observed. That’s part of the reason why the FDA is authorizing a booster shot for kids between 5 and 11 years old.

Regulators on Tuesday OK’d a single booster dose of Pfizer and BioNTech’s mRNA vaccine for children who received their primary series with the same vaccine at least five months ago. By Pfizer’s count, that makes more than 8 million 5- to 11-year-olds eligible for another dose.

Usually reserved for making decisions on drug applications or enforcing what Congress stipulates, the FDA is now dipping its toe into the wild world of congressional politics as it attempts to fix a major court decision that could have a chilling effect on rare disease R&D.

The case in question from last October saw a US appeals court overturn a prior FDA court win, saying that the agency never should’ve approved a rare disease drug because a previously approved but more expensive drug with the same active ingredient has orphan drug exclusivity barring such an approval.