Despite the warnings of SARS, MERS, swine and bird flu, the coronavirus COVID-19 took the entire world by surprise. Governments, health workers and pharmaceutical executives were unprepared for the rapid spread of the pandemic across the globe. Now they are racing against time to find a cure for the millions who will be affected in the coming weeks and months. 

We have mentioned potential treatments for COVID-19 in previous Proventa articles. Until now, however, we have not looked specifically at the companies combating the threat of coronavirus. Currently several organisations are racing to create an effective vaccine, fuelled by Chinese efforts to sequence the disease and earlier efforts to create generic coronavirus vaccines. 

So far, Moderna has been the first company to offer patients doses of its trial vaccine. This encodes for a perfusion stabilised form of the Spike (S) protein. This is just the first stage of a number of trials expected to stretch out to 2021, however. More time will pass until patients in hospitals worldwide begin to see cures for their own illness. 

The five treatments currently furthest into development are: 

• Gilead’s remdesivir, a broad-spectrum antiviral treatment tested previously for use against Ebola, with promise shown in treatment of SARS and MERS. Facing overwhelming demand for the drug, Gilead has asked the FDA to rescind its decision to declare remdesivir an orphan drug. This is due to public criticism that this could allow the company to overcharge for it
• Abbvie’s Kaletra, a combination of HIV antivirals lopinavir and ritonavir. This has had its global patents suspended to enable the creation of generics, though the drug recently disappointed in Chinese trials of patients with minor COVID-19
• Moderna’s mRNA candidate mRNA-1273. This is currently the most promising candidate with trial results promised in two months. Emergency vaccines will be potentially available by Autumn 2020
• Regeneron/Sanofi’s Kevzara, an arthritis drug being tested in severe COVID-19 infection, which inhibits the interleukin-6 pathway. The companies are enrolling up to 400 patients in a phase 2/3 study to assess how the drug reduces fever and reduces need for supplemental oxygen
• Toyama Chemical’s favipiravir/favilavir, an antiviral drug active against a number of RNA viruses. Chinese authorities suggested this is “clearly effective” in trials involving 340 COVID patients and produced positive outcomes

Overall, there are 60 active drug developers worldwide working on treatments for Coronavirus, from research centres to major pharma companies. Some of the others in the race include:

• Arcturus Therapeutics, currently in preclinical development with a vaccine that engineers RNA and allegedly has a better immune response at a lower dose than competitors
• Eli Lilly, in the preclinical stage with antibody treatments extrapolated from coronavirus survivors’ blood. This company is working to find the most potent antibody for human trials in the next four months
• GSK, lending proprietary adjuvants to a Chinese biotech company injecting proteins into patients to bring on an immune response
• Sanofi, which is using coronavirus RNA mixed with genetic material from a harmless virus to create a cocktail that can prepare an immune system without infecting patients

This intense race has seen some record-breaking feats. Moderna, for example, went from identification of the virus to creating a test-ready vaccine in just 42 days. As yet, however, it is clear responses have still not been fast enough. Over the last few months the world has seen how quickly and efficiently such a virus can work. Without systems already in place we have seen how dangerous even a moderate virus can be. ‘Quicker than ever’ is not enough in and of itself. But it is one step towards preventing another virus having the impact COVID has had on the world. 

Joshua Neil, Editor
Front Line Genomics