University College London Hospitals (UCLH) has announced neutralising antibody trial against COVID-19. The announcement on 25 December 2020 says ‘’UCLH doses first patient in the world in Covid-19 antibody trial’’ and ‘’ Researchers in the STORM CHASER study led by UCLH virologist Dr Catherine Houlihan have recruited the first participant in the world to the study’’ (1).
The antibody under clinical trial in UCLH is AZD7442 which is a combination of monoclonal antibodies (mAbs) developed by AstraZeneca. This combination is already undergoing clinical trials in the USA since December 2, 2020 (2) . Several other ‘antibodies’ and ‘antibody cocktails’ are undergoing clinical trials elsewhere (3). The combination of antibodies in AZD7442 have been modified to extend their half-life to afford protection for six to 12 months. More importantly, they have been engineered for reduced Fc receptor binding that aims to minimise the risk of antibody dependent enhancement of disease- a phenomena in which antibodies to the virus promote, rather than inhibit infection (4).
These neutralising antibodies are an important tool for providing protection in patients with a weak immune system and where the disease has already progressed far (3). Vaccines provide active immunity, however immunity development through vaccines may take some time and may be ineffective after infection has been contracted. Providing passive immunity through ready-made, exogenous antibody is the way forward to give quick protection to immune compromised patients and patients with full blown disease.
Two studies are planned. The STORM CHASER study aims to evaluate effectiveness of monoclonal antibody AZD7442 for immediate protection to people who have been recently exposed to the SARS-CoV-2 virus, to prevent them developing Covid-19; while the other study namely PROVENT aims to evaluate the antibody AZD7442 in people who has a compromised immune system who will not respond to vaccines or are at higher risk due to factors such as age and existing conditions.
Further research and clinical investigations using different combinations of neutralising antibodies to SARS-CoV-2 virus would pave the way for providing protection to not only the vulnerable population with a weak immune system and people having the disease but will also protect otherwise healthy individuals from contracting the disease when administered with these antibodies.
- UCLH 2020. News. UCLH doses first patient in the world in Covid-19 antibody trial. Published December 25, 2020. Available online at https://www.uclhospitals.brc.nihr.ac.uk/news/uclh-doses-first-patient-world-covid-19-antibody-trial Accessed on 26 December 2020.
- NIH 2020. A Phase III Randomized, Double-blind, Placebo-controlled, Multi-center Study in Adults to Determine the Safety and Efficacy of AZD7442, a Combination Product of Two Monoclonal Antibodies (AZD8895 and AZD1061), for Post-exposure Prophylaxis of COVID-19. Available online at https://clinicaltrials.gov/ct2/show/study/NCT04625972 Accessed on 26 December 2020.
- Prasad U., 2020. New Strains of SARS-CoV-2 (the virus responsible for COVID-19): Could ‘Neutralising Antibodies’ Approach be Answer to Rapid Mutation?. Scientific European Published 23 December 2020. Available online at https://www.scientificeuropean.co.uk/new-strains-of-sars-cov-2-the-virus-responsible-for-covid-19-could-neutralising-antibodies-approach-be-answer-to-rapid-mutation/ Accessed on 26 December 2020.
- AstraZeneca 2020. Press release. COVID-19 Long-Acting AntiBody (LAAB) combination AZD7442 rapidly advances into Phase III clinical trials. Published 09 October 2020. Available online at https://www.astrazeneca.com/media-centre/press-releases/2020/covid-19-long-acting-antibody-laab-combination-azd7442-rapidly-advances-into-phase-iii-clinical-trials.html Accessed on 26 December 2020