Antibody trial halted for lack of effect

6 minute read

Eli Lilly has halted its trial of bamlanivimab in patients hospitalised with COVID-19 as early data suggested the therapy was not going to be of benefit.

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  • Eli Lilly has halted its trial of a neutralising antibody treatment in patients hospitalised with COVID-19 because early data suggested the therapy was not going to be of benefit.
    The drug, called bamlanivimab (and who now has the chorus from ‘Black Betty’ stuck in their heads?), is also being trialled in a number of other studies, including the NIH-sponsored ACTIV-2 trial in mild to moderate COVID-19, and BLAZE-1 in non-hospitalised COVID-19.
  • Living in a residential care home is associated with a four-fold higher risk of COVID-19 mortality among the elderly, according to a population-based study from Sweden.
    Researchers used data from the cause-of-death register for more than 274,000 Stockholm residents aged 70 of over to look for associations between housing characteristics, neighbourhoods and COVID-19 deaths.
    The results, published in The Lancet Healthy Longevity, found the highest mortality levels were among individuals living in care homes. Those in the most crowded living conditions (less than 20m2 per individual) had a two-fold higher risk of COVID-19 mortality than those in the least crowded conditions (more than 60m2 per individual). The study found higher mortality among those living with someone of working age or living alone, compared to those living with someone aged 66 years or older. COVID-19 mortality was also higher in more densely populated areas of the city and in those with a higher incidence of COVID-19.
  • The secondary transmission rate for COVID-19 in New South Wales schools has been low, and the outbreaks that have occurred have been quickly contained, according to a report by the National Centre for Immunisation Research and Surveillance.
    NCIRS has published its Term 3 report on COVID-19 in schools in the state, which found the secondary transmission rate in primary schools was 0.4%, high schools was 1.1% and 0.7% for early childhood centres.
    Altogether this term, the state has had 34 schools investigated for a COVID-19 case in staff or students who attended while infectious. From the 39 primary cases, there were 33 secondary cases, and these included three larger outbreaks. The authors commented that these outbreaks involved factors such as primary cases attending school while symptomatic, a non-school-related overnight retreat, and participation in a music group.
  • A population-based cohort study of more than 35,000 residents of Wuhan has found nearly 4% have antibodies against SARS-CoV-2, despite very few having ever tested positive with RT-PCR.
    The study, published in JAMA Network Open, found the prevalence of seropositivity was significantly higher in urban areas compared to suburban and rural areas, significantly higher among women than men, and was highest among those aged 60 years and older.
  • A randomised controlled trial of convalescent plasma in people with moderate COVID-19 has found no impact on time to progression or all-cause mortality, according to a paper published in the BMJ.
    Researchers randomised adults admitted to hospital with moderate COVID-19 either to two doses of plasma taken from individuals who had previously recovered from COVID-19, or standard of care alone.
    The study found no significant difference between the two groups in the time it took to progress to severe disease, nor was there any difference in all-cause mortality.
    The authors also looked at whether there was any effect based on the quantity of neutralising antibodies in the convalescent plasma, but still found no difference in the primary outcomes.
    “Although the use of convalescent plasma seemed to improve resolution of shortness of breath and fatigue in patients with moderate covid-19 and led to higher negative conversion of SARS-CoV-2 RNA on day 7 post-enrolment, this did not translate into a reduction in 28 day mortality or progression to severe disease,” they wrote.
  • Health practitioners who are unable to meet the minimum number of hours of practice requirements in order to renew their registration can still apply to renew and instead meet those requirements next renewal.
    The Australian Health Practitioner Regulation Agency says it has implemented the temporary measure in recognition of the fact that some practitioners may be struggling to meet the recency of practice registration standard requirements because of the pandemic, due either to an impact on employment or patient numbers.
    “Practitioners will need to meet the recency of practice standard requirements as set out in the relevant Recency of practice registration standard when they apply for renewal in 2021,” AHPRA said in a statement. The policy came into effect on October 22, and will remain in place until 31 January 2021.
  • How can CPR be done safely on a person with COVID-19? Good question, and one that Australia’s National COVID-19 Clinical Evidence Taskforce has addressed in its latest update.
    The Taskforce has published three new flowcharts: one on preparing for CPR during the pandemic, one on actually doing CPR on an individual with COVID-19, and one how to perform basic life support for an adult in community setting.
    The latest update also includes a recommendation against using hydroxychloroquine for pre-exposure COVID-19 prophylaxis in healthcare workers.
  • The risk of death among patients hospitalised with COVID-19 is five times higher than for those hospitalised with influenza, a new study has found.
    A report in Morbidity and Mortality Weekly Report presents retrospective analysis of electronic health record data for 3,948 patients hospitalised with COVID-19 during March-May 2020 and 5,453 hospitalized patients with influenza between October 2018 and February 2020.
    Twenty-one percent of patients hospitalised with COVID-19 died in hospital, compared to nearly 4% of those hospitalised with influenza, representing a five-fold higher rate of in-hospital mortality with COVID-19. Those with COVID-19 also had a nearly 19-times higher risk of developing acute respiratory distress syndrome, more than double the risk of myocarditis, 2.8-times higher risk of deep vein thrombosis, 2.1-times higher risk of pulmonary embolism, and more than three-fold greater risk of acute hepatitis or liver failure.
    Twice as many patients with COVID-19 were admitted to intensive care than those with influenza, and they stayed in hospital for three times as long.
    The study also found that Black and Hispanic patients were at significantly higher risk of respiratory, neurological and renal complications, and sepsis, compared to White patients, even after adjusting for age and other medical conditions.
    While the patients with COVID-19 were slightly older on average than those with influenza, they had a lower prevalence of underlying medical conditions.

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