The latest Investing Matters Podcast episode featuring Jeremy Skillington, CEO of Poolbeg Pharma has just been released. Listen here.
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Thanks Matml, it's a good point re activ P3 and the breathless at home. I would think 'breathlessness' is one of the first indications of 'moderate' covid over 'mild'
I read it! It worried me a little. I could see the logic behind it! And I had not actually considered it once! If results indicated that inhaled interferon given at the right time predisposed more people to long COVID than compared to placebo group then that, I think is game over for covid treatment but not so ASTHMA nor COPD and others.
Conversely the elevated interferon levels in long COVid patients can potentially be put down to the fact that the body is, of course, still fighting the damn disease!
Like all of us…. We hope and pray
GLA
I did Doc. It was a small sample size (31) Long covid sufferers and 8 of those had very severe disease so you might expect higher levels of cytokines with them. It may be a problem but I think there is not enough understanding about long covid yet to get too concerned. I suspect if you can control the virus early and quickly for those with poor innate immunity then long covid won’t be an issue for most.
Matml74, did you read that tweet on long Covid and how they were suggesting IFNb was perhaps not good long term? I read it but I’ll admit a lot of it went straight over my head.
Brand, there is a graph in the April presentation that shows for the mild/moderate cohort there was no difference between SNG vs placebo in recovery time. I guess it depends on what is trying to be achieved by treating mild covid disease. I believe that Activ P3 is taking a more targeted approach for SNG001 and focussing on the breathless at home. I think there will definitely be a roll for the drug in that area. I think we probably got through the Activ P2 by showing good viral reduction and if that is shown to be of benefit, particularly in terms of long covid, then there might be wider application for the drug.
Thanks Matml, I completely agree and imo this is what separates SNG from so many other treatments, and why It's such a potential game changer (it also makes it much easier to justify the cost)
But is it not also right that we haven't seen a large enough trial to show SNGs effectiveness in mild to moderate patients? And that while data to date may show the most benefit Vs the breathless cohort, there is still every chance it will show benefit Vs mild to moderate patients as well? The home trial didn't show statistical significance, but there was some benefit Vs placebo, and of course Activ progressed to P3
From what I recall, the A2P3 trial is meant to treat 800 patients w SNG, which given everything we have learned about inhaled interferon beta, I believe will show strong efficacy.
Brand, All good points but IMO they have worked that out already. It's the breathless. I went back through the April 21 presentation today. It is really quite compelling piece of work and really highlights why the breathless cohort is the one the drug works best in. I recommend all take a read again.
A p value of 0.004 is a very significant result!
Brand.
Thank you. Because when I was reading the recent Lancet article - published December and discussing Sotrovimab and the Brii's for hospitalized patients - I realized there fine distinctions re prescription of a drug - it can be useful for some patients but not for others - and as you point out, costs come into these discussions. Things are slow, subtle and careful out there.
This is all imho, but from what we've seen in the peer review studies that have been published since progression to A2P3, it's been well established that INFb is 'potent' (SNGs words) vs SARS-CoV-2.
What data from both Activ and Sprinter should tell us is the 'window' for treatment with SNG001. Given the data we've seen so far, it's most likely is that it is effective from first infection to when the virus has cleared the body. I think a big question is, is it worth £2k a treatment from first infection when most people recover on their own? Perhaps a lower dosage or number of treatments would be in order from first infection, this is the kind of data we should be hoping for from ACTiV imv.
The journal of immunology study mentioned it's potential as a prophylactic, tho I have seen that the INFa nasal spray that was utilised in China has had issues with inflammation in the nostrils and sinuses - it may be a bit extreme to have everybody huffing on INFb everyday to ward off the virus, but it could certainly be helpful in an outbreak scenario.
So I don't think is a scenario where it is one or the other, what we should learn between the two studies is the range (for lack of a better word) for SNG.
GLA
Is the market for a therapeutic for mild to moderate Covid patients significantly smaller or larger than the market for a therapeutic for hospitalized Covid patients? That would mean you could fail P3 but hit real gold on Activ-2? Or am I just looking seriously ignorant. Again. :)