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Research Roundup: AstraZeneca vaccine receives use recommendations, Eli Lilly antibody authorized by FDA, and an anti-inflammatory drug cuts deaths in trial
In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week.
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On Wednesday, a World Health Organization (WHO) panel recommended the use of AstraZeneca and the University of Oxford’s COVID-19 vaccine for all adults over 18. The recommendation is not an official emergency use listing but could pave the way to broader use of the vaccine—including by the COVAX Facility and African Vaccine Acquisition Task Team, both of which have secured hundreds of millions of doses with plans to distribute to participating countries in the coming months. On Thursday, Africa Centers for Disease Control and Prevention (CDC) Director John Nkengasong said his organization was also recommending use of the AstraZeneca/Oxford vaccine, except for in countries where the B1351 COVID-19 variant, first identified in South Africa, has become dominant. Africa CDC made its decision after data from a study in South Africa indicated poor efficacy of the vaccine in preventing mild to moderate illness caused by the variant, while WHO did not make the same specification, noting that the vaccine was still likely to be effective in preventing more severe COVID-19 cases.
The US Food and Drug Administration (FDA) on Tuesday granted emergency use authorization (EUA) to Eli Lilly’s combination monoclonal antibody therapy to treat mild to moderate cases of COVID-19 in patients ages 12 and up who are at high risk for progressing to severe disease. The therapeutic, a combination of bamlanivimab and etesevimab, cut the risk of hospitalization and death among COVID-19 patients by 70 percent in a late-stage clinical trial. The FDA had previously issued an EUA for bamlanivimab in November. New protocols have also enabled a shorter infusion time for bamlanivimab alone and with etesevimab, reducing it from an hour to as few as 16 and 21 minutes, respectively. Eli Lilly has so far made 100,000 doses of the combination therapy available and plans to manufacture an additional 150,000 throughout the first quarter of 2021.
The anti-inflammatory drug tocilizumab, most often used to treat rheumatoid arthritis, helped reduce the COVID-19 death rate in a major clinical trial based in the United Kingdom. The RECOVERY Trial tested a group of 2,022 patients receiving tocilizumab, 82 percent of whom also received dexamethasone or a similar steroid, against a control arm of 2,094 patients receiving standard care alone. Results from the study, released last week and not yet peer-reviewed, showed that tocilizumab reduced the rate of death by 14 percent, with a larger reduction among patients on ventilators. Tocilizumab also increased the probability of discharge within 28 days from 47 percent to 54 percent.