Eli Lilly's Covid-19 antibody drug treatment gets emergency USFDA clearance

Eli Lilly & Co.’s antibody therapy was granted an emergency-use authorisation by U.S. drug regulators for treating Covid-19, widening access to a treatment that early data suggests is effective in keeping people infected with the coronavirus out of the hospital.

The Food and Drug Administration authorised the experimental treatment, called bamlanivimab, for use against mild-to-moderate Covid-19 in adults, including those who are 65 and older, and pediatric patients, the agency said on its website.

Shares of the Indianapolis-based Lilly gained 4.5% in late trading on Monday. Through the close, the stock had advanced 8.3% so far this year.

The clearance gives doctors an option for tackling the virus in high-risk patients before they’re sick enough to require hospitalisation. Other treatments that received the regulatory go-ahead, such as convalescent plasma, a component collected from the blood of recovered Covid patients containing immune factors, and Gilead Sciences Inc.’s antiviral remdesivir, are intended for use in severely ill Covid-19 patients.

Now begins an even more difficult challenge: distribution. Lilly said in a statement Monday that bamlanivimab should be administered “as soon as possible after a positive Covid-19 test and within 10 days of symptom onset.” Lilly will begin shipping the antibody therapy immediately to AmerisourceBergen Corp., which will distribute it as directed by the U.S. government. Americans will have no out-of-pocket costs for the medicine, the company said, while acknowledging that health-care facilities may charge a fee for the product’s intravenous administration.

Experimental antibody treatments could become a powerful component of the arsenal that doctors use to treat the coronavirus. Anthony Fauci, the top U.S. infectious-disease official, has referred to antibody-based medicines as a bridge to a vaccine. The class of treatments was thrust into the spotlight after President Donald Trump received an antibody made by Regeneron Pharmaceuticals Inc. after becoming infected with Covid-19.

The therapies, which rely on lab-made proteins that mimic the immune system’s ability to fight off the virus, also are being studied as short-term treatments that could be given to people such as nursing-home residents or staff who may have been exposed during a local outbreak to prevent them from getting sick.

Lilly approached the FDA for authorisation of the single-antibody treatment it’s developing with Canadian biotech AbCellera Biologics Inc. last month. Meanwhile, U.S. regulators have yet to decide whether Regeneron’s antibody cocktail will get an emergency-use green light.

Lilly and closely held AbCellera’s monotherapy antibody treatment reduced the rate at which symptomatic patients were hospitalised or sent to emergency rooms compared with a placebo, according to interim study results released by the company in September. Trial results published in the New England Journal of Medicine showed the therapy reduced patients’ viral load at the middle of the three doses studied.

The U.S. government will pay Lilly $375 million for 300,000 vials of the antibody treatment. The initial agreement is for delivery over the first two months following a regulatory green light. The U.S. also has the option to purchase an additional 650,000 vials through next June for as much as $812.5 million.

Lilly is also studying a cocktail of two antibodies. The company expects to approach regulators for authorisation in November and seek full approval in the second quarter of 2021. Early results from a trial showed the combination reduced virus levels in patients with mild to moderate Covid-19 and cut the rate of hospitalisations and emergency room visits.

The drugmaker has a manufacturing partnership with Amgen Inc., among others, and plans to pursue more collaboration pacts, according to Chief Executive Officer David Ricks.

Infectious disease experts say antibody drugs are most likely to be useful if they are given early on in the course of infection. That idea was bolstered on Oct. 26, when a government-sponsored trial of the Lilly antibody in hospitalised patients—who tend to be sicker—was terminated due to lack of efficacy.

The FDA said explicitly on Monday that bamlanivimab is not authorised for patients who are hospitalised due to Covid-19 or require oxygen therapy after contracting the disease. It said the broader class of monoclonal antibodies may be associated with worse clinical outcomes when administered to hospitalised patients who have become infected with the virus and are in need of high flow oxygen or mechanical ventilation.

Other companies testing antibody treatments include Regeneron Pharmaceuticals Inc., AstraZeneca Plc and GlaxoSmithKline Plc and its partner Vir Biotechnology Inc.