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Bay Area search for coronavirus drugs extends far beyond remdesivir

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Remdesivir, the antiviral drug made by Foster City’s Gilead Sciences that has recently shown promise in treating COVID-19 patients, will likely not turn the tide of the coronavirus pandemic on its own.Doctors in the Bay Area know that, which is why they’re studying a host of other potential treatments that could be used to alleviate the worst symptoms of COVID-19 or keep people out of the hospital entirely. And the scope of the local research seems to be broadening.The regional efforts raise the possibility that a major advancement in coronavirus treatments could come from the Bay Area, a research powerhouse that has produced drug breakthroughs before. But they have many competitors, as more than 220 treatments for the virus are in consideration worldwide, according to the Milken Institute.Like remdesivir, many of the drugs were originally designed for another purpose and are being re-evaluated for use against the novel coronavirus. But at least one local company is investigating the possibility of a brand-new drug made specifically for coronavirus infections.Some potential treatments might be used in tandem with remdesivir. Others could, if shown to be effective, help prevent COVID-19 patients from ever needing the Gilead drug.“Remdesivir is not a silver bullet,” said Lloyd Minor, dean of Stanford University’s School of Medicine. “It’s not the type of drug that you give it to someone and they’re instantly cured of this virus. But it’s an important first step, and now there will likely be other trials that use remdesivir and add another drug to the treatment regimen.”Early results released a few weeks ago from a federally sponsored clinical trial of remdesivir indicated that the drug helped for COVID-19 patients to leave the hospital. The data was peer reviewed and published on Friday in the New England Journal of Medicine.Dr. Anthony Fauci, the federal government’s leading infectious-disease expert, said when discussing the preliminary data in late April that the trial results were “quite good news” and “a very important proof of concept.”Now the federal government is another clinical trial that will pair remdesivir with an anti-inflammatory drug called baricitinib. That drug, which is licensed to the Indiana pharmaceutical company Eli Lilly and Co., is an approved treatment for rheumatoid arthritis.Gilead spokesman Chris Riley said in an email that the company is “monitoring emerging data on other drugs being explored” to treat COVID-19. He noted the federal trial involving remdesivir and baricitinib, and said Gilead researchers are also evaluating the “future potential” to make inhaled or oral forms of remdesivir, which patients currently receive intravenously.“Addressing COVID-19 is going to take the collective efforts of many organizations across the private and public sectors,” Riley said in the email. “Gilead and many of our peers in the biopharmaceutical industry are working around the clock to develop treatments, vaccines and diagnostics for COVID-19 and we will need a combination of these elements to help stop the spread of this virus.”Additionally, the Washington state drug company CytoDyn wants federal officials to authorize a coronavirus clinical trial that would compare its experimental HIV drug leronlimab to remdesivir and test how the two treatments work together.Leronlimab is a lab-made antibody that its maker hopes will fight COVID-19 in part by targeting the intense immune system response that triggers severe symptoms for many patients. CytoDyn’s chief medical officer and a company doing diagnostic testing for the drug maker are both based in the Bay Area.Dr. Bruce Patterson, CEO of IncellDx, the diagnostic company partnering with CytoDyn, said initial results from COVID-19 patients that received leronlimab have been encouraging. Clinical trials of the drug are ongoing.“COVID-19 is clearly two different diseases,” Patterson said. “In the early stages, it’s virologic — the virus is replicating. It’s building up a significant viral load. Then there is an immunologic switch that says all of a sudden this is an immunologic disease.”Research that Patterson helped lead indicates that patients infected by the coronavirus may have high levels of a certain signaling protein that is blocked by leronlimab. The research is still being peer reviewed.More for youStanford doctors are investigating whether another drug called interferon-lambda could help patients in the early stages of COVID-19.Given through an injection similar to insulin, interferon-lambda is a manufactured version of a naturally occurring protein that was previously used in clinical trials for people with hepatitis infections, according to Stanford. It works by “revving up the body’s immune system” to fight off the infection, rather than directly interfering with how the virus replicates, said Dr. Upinder Singh, a Stanford infectious-disease expert.The Stanford trial plans to enroll 120 patients, half of whom will receive a placebo. Doctors are looking for patients who were recently diagnosed with COVID-19 to see if the drug can help prevent hospital stays.“If the drug works and is proven effective, then you can get a single shot of this hopefully early in your disease, fight the virus off and then you’re done,” Singh said.Minor, the Stanford dean, said that effective outpatient treatments for coronavirus infections — which is what interferon-lambda would be if it works — could be a very useful tool during the pandemic.“If we can ... identify those therapies and then roll them out to make them broadly available, that will really help us get through these next several months to a year — or perhaps even more — until a vaccine is developed,” he said.Updated to include drought zones while tracking water shortage status of your area, plus reservoir levels and a list of restrictions for the Bay Area’s largest water districts.Similarly, UCSF researchers are starting a new outpatient trial that will study whether azithromycin, a widely used antibiotic, helps slow COVID-19 progression in patients who have not been admitted to the hospital. The trial will be run remotely, and it plans to enroll 2,300 people nationwide, a third of whom will be in a control group.Some Kaiser Permanente hospitals in Northern California are participating in a coronavirus clinical trial of a different drug, selinexor.Selinexor is an anticancer drug that blocks an important protein in the cellular machinery for DNA processing, and it has antiviral and anti-inflammatory aspects that may be useful to fight coronavirus infections, according to Kaiser’s Dr. Jacek Skarbinski. Kaiser hospitals in San Francisco, Oakland and Sacramento are involved in the study, which aims to enroll about 250 patients nationwide, he said.The drug, which is administered orally, will initially be intended for patients with severe symptoms, Skarbinski said. But its use could expand if it works.“If it’s successful and it has a reasonable safety profile, then it could be used in the outpatient setting, so that is one promising part of this,” Skarbinski said. “Remdesivir is an IV medication that, at this time, can only be used in an inpatient setting.”That’s not to say that remdesivir lacks benefit. Skarbinski has been involved with Kaiser’s participation in coronavirus clinical trials of remdesivir, and he said the data that’s been published about the drug so far has been encouraging.Victor Godinez-Cubillo, a 60-year-old Daly City resident, received remdesivir after he was admitted to Kaiser’s South San Francisco hospital due to a coronavirus infection. He was connected to oxygen but never put on a ventilator, and he said he began to improve the day after his remdesivir treatments started. He was out of the hospital in about five days.“I could do more things. I could breathe for myself,” Godinez-Cubillo said. “I started to do better and better and better until I finished the remdesivir.”While many others try to redirect existing drugs toward COVID-19, San Jose biotech company Anixa Biosciences hopes to unearth a brand new treatment. The company is using artificial intelligence to screen a computer database of about 1.2 billion compounds that might be fashioned into coronavirus drugs.Already, Anixa has identified one protein that could become an antiviral treatment for coronavirus patients, according to CEO Amit Kumar. The company is now conducting laboratory tests that, if successful, would pave the way for animal studies.“Our assertion is that better drugs and better therapies will be available if we target the machinery of this specific virus, as opposed to taking other drugs that have targeted the machinery of other viruses and diseases and then repurposing them for this particular disease,” Kumar said.J.D. Morris is a San Francisco Chronicle staff writer. Email: Twitter:Updated to include drought zones while tracking water shortage status of your area, plus reservoir levels and a list of restrictions for the Bay Area’s largest water districts.

Remdesivir, the antiviral drug made by Foster City’s Gilead Sciences that has recently shown promise in treating COVID-19 patients, will likely not turn the tide of the coronavirus pandemic on its own.Doctors in the Bay Area know that, which is why they’re studying a host of other potential treatments that could be used to alleviate the worst symptoms of COVID-19 or keep people out of the hospital entirely. And the scope of the local research seems to be broadening.The regional efforts raise the possibility that a major advancement in coronavirus treatments could come from the Bay Area, a...

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J.D. Morris

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Bay Area search for coronavirus drugs extends far beyond remdesivir

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