Did Trump get a magic cocktail of antibodies?

Antibody treatment can quickly prove to be an important treatment option alongside vaccines.

President Donald got a cocktail of designer antibodies when he got covid-19 earlier this fall. Here he is on his way home from hospital after treatment. Foto: Evan Vucci / AP, NTB

  • Jan Terje Andersen

    Jan Terje Andersen

    Professor, University of Oslo, Oslo University Hospital and member of the Academy for Young Researchers (AYF)

Oct 29 2020 08:00

Last updated just now

The knowledge is Aftenposten’s investment in research and science, where researchers and professionals from all over the country contribute articles.

After President Donald Trump received covid-19, he was given a cocktail of drugs with the hope of recovering quickly in the oval room. The cocktail contained designer antibodies.

Contrary to Trump’s countless hopeless statements about promising drugs, antibody treatment can quickly prove to be an important treatment option alongside vaccines. Especially for those who respond poorly to the vaccine, such as the elderly in the risk group.

Antibodies can also be given as preventive medicine since they have a long duration of action in the body. Such treatment will be relevant for health personnel, people in key societal functions and those in the risk group.

However, although designer antibodies may prove to slow down the coronavirus effectively, there are concerns about the availability and cost of such treatment.

Jan Terje Andersen is professor of biomedical innovation at the University of Oslo and group leader at Oslo University Hospital, Clinic for Laboratory Medicine. Photo: Tuva Holt Hereng

The possibilities of biotechnology

When we are exposed to a viral infection, the body begins to defend itself. It makes antibodies that attach to the virus. If the antibodies are of good enough quality, they can put the virus in check.

Antibodies are therefore the body’s self-produced medicine. They are also made by vaccination.

However, the body does not always understand which antibodies it should produce sufficiently to fight the infection. But with biotechnological methods, we can isolate the very best antibodies from people who have been through a disease course.

The antibodies can be further adapted in the laboratory so that they work even better. Then we get designer antibodies that can be produced in large quantities in factories.

Never before have we seen a faster production of antibodies than during this pandemic. More than 150 variants have been registered, where 11 different strategies are now being tested on humans in the shadow of the vaccine races.

Two of these have submitted applications for urgent approval to the Food and Drug Administration (FDA), an agency under the US Department of Health and Social Services. One was given to Trump.

Experimental antibody cocktail

Before drugs are approved by the authorities, they are tested on humans, so-called experimental treatment. Trump thus received a treatment that is not yet available to the public.

The cocktail was developed by Regeneron Pharmaceuticals and consists of two antibodies. One is isolated from a person who has been through covid-19, while the other is taken from vaccinated mice with a engineered human immune system.

Both antibodies bind to the spike protein that protrudes on the surface of the coronavirus, blocking the virus from entering our cells. The cocktail has been shown to reduce the amount of virus and lung damage in monkeys and is now being tested on different patient groups.

The company reported at the end of September that the treatment has a good effect and shortens the time with symptoms in non-hospitalized patients. There is now great tension associated with data from larger patient groups.

Regeneron Pharmaceuticals is a reputable US company that has succeeded in bringing several antibody products to market. On October 14, they were approved for a cocktail of three antibodies to treat Ebola infection in adults and children.

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Fair accessibility

Antibodies are the fastest growing group of drugs that relieve bothersome symptoms and save lives.

They are widely used in the treatment of cancer and chronic inflammatory diseases, but also in the treatment of severe migraines and hemorrhagic diseases. Almost 600 antibodies are now being tested clinically.

Infectious diseases have not been a major focus in the first place. This is due to costly development trends and uncertainty related to demand. This is due to the fact that infectious diseases dominate in countries with a small degree of infrastructure and ability to pay. This has major and serious consequences for global health.

As much as 80 percent of the antibody market is in the United States, Europe and Canada. This means that 85 percent of the world’s population does not have access to effective antibody treatment.

This cannot continue.

Steps must be taken to ensure fair access to a reasonable price by investing in technology that reduces development costs. Business models must be in place that enable different market approaches. This is important now that we are in the middle of a pandemic. Fair distribution of vaccines is crucial, as are other treatment options to get the coronavirus under control.

Adapted to the most vulnerable

The research group I lead collaborates with the International AIDS Vaccine Initiative (IAVI), which is a global, non-profit organization, where the goal is to develop HIV antibodies that are long-acting, preventive and adapted to the most vulnerable.

Recently, IAVI, together with Wellcome, a politically and financially independent foundation, launched a report with the necessary measures to ensure fair global access to antibody treatment.

On October 22, IAVI also announced its own strategy for commercializing designer antibodies directed against the coronavirus. It is happening together with Merck KGaA in Germany and the Serum Institute in India. The strategy is aimed at vulnerable groups in low-income countries.

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