A ‘breakthrough’ treatment for Covid-19
The TLDR: The spectacular trial results of a new treatment is stirring great excitement—and anxiety—in the medical community. The drug appears to be highly successful in preventing patients from becoming seriously ill. But scientists worry about rushing to embrace a ‘miracle cure’ without sufficient testing.
What’s this new drug?
Developed by the UK company Synairgen, it uses a protein called interferon beta. This is something our body naturally produces when it detects a threat. There are three kinds of interferons. Here is how interferon beta works:
- When a virus enters our system, each cell shoots “an emergency flare” of interferon to alert the immune system.
- Interferon beta specifically activates white blood cells, natural killer cells (NK cells), and a type of T cell—all of which then target and kill the virus.
- More importantly, there is evidence that this coronavirus blocks the production of interferons—and significantly weakens or delays the body’s immune response.
How the drug works: It boosts interferon beta levels by delivering it directly to the infected area, i.e. the lungs. It is literally inhaled by patients via a nebuliser.
Tell me about these ‘spectacular’ results
A clinical trial involved 101 patients in nine British hospitals. And it showed that the drug cut the odds of a person becoming seriously ill by 79%! Also this:
“Patients were two to three times more likely to recover to the point where everyday activities were not compromised by their illness, Synairgen claims. It said the trial also indicated "very significant" reductions in breathlessness among patients who received the treatment.
In addition, the average time patients spent in hospital is said to have been reduced by a third, for those receiving the new drug—down from an average of nine days to six days.”
And that’s why it is being hailed as a big “breakthrough” in Covid treatment.
So why the worries?
One: The trial size is small. And the company published the results after just two weeks. So there’s little indication of more serious side-effects that may kick in with a larger or more diverse sample—or over a longer period of time.
Two: Interferon-beta has been safely used to treat multiple sclerosis, but in the injectable form. The inhaled version of the drug is not yet licensed or widely available.
Three: The trial is yet to be peer-reviewed, and the company has not yet shared all its data.
So this may just be hype?
No, there is a very good chance that interferon-based treatments can work. One expert tells the New York Times:
“[E]vidence was piling up that administering interferon could help limit the replication of the virus, especially in the early stages of illness, fending the virus off for long enough that a second set of genes could successfully eradicate it.”
And there are a wide variety of other trials that are experimenting with different varieties of interferons—alpha, beta and lambda. A study in China showed that interferon nasal drops may help protect frontline workers from infection. Another published study—which used interferon alpha—found that it rapidly cleared the airways of patients with moderate symptoms.
Also in India: the Indian company Zydus Cadila is already testing a form of interferon alpha—usually used against hepatitis B and C—and recently received approval for trials in Mexico.
Point to note: Interferon treatments only work in patients with mild to moderate symptoms. They produce dangerous side-effects in serious cases. Right now, only Dexamethasone and Remdesivir have been approved for such patients.
Is it ready to use?
Not yet. The company has to present the results to get government approval. This usually takes months, but many governments have fast-tracked approvals—especially of drugs already being used to treat other diseases. Even Synairgen says it will be able to deliver only "a few 100,000" doses a month by the winter.
Point to note: One challenge in conducting wider interferon trials is the lack of a sufficient number of new infections in places like the UK. It explains why some scientists are actively seeking partners to conduct clinical trials on interferon alpha treatments in India.
The bottomline: Any new drug that prevents infection or even serious complications will be a game-changer for countries that have weak or under-resourced healthcare systems. Example: India.
New York Times and BBC News have the best overviews of the new drug. The Scientist takes an in-depth look at the use of interferons to treat Covid-19. Also in BBC News: an excellent explainer on where we are in terms of finding a cure. Related news: Remdesivir will now be sold in India under the name ‘Desrem’—and will cost Rs 4,800 per 100 mg vial.