The latest Investing Matters Podcast with Jean Roche, Co-Manager of Schroder UK Mid Cap Investment Trust has just been released. Listen here.
Hold4results - thank you. 5 is better than 3. Just 15 more to go. I remain frustrated by the adverse effect of Recovery on the ground, their key goal seeming to be hoovering huge numbers of cases into their net.
The only key message I get from this is that only 3 sites are recruiting in England as of 1 February: Hull, Birmingham and Southampton. Is this because the super-trawler called Recovery is squeezing us out? And no mention of any starts elsewhere. Please correct me if I am missing something.
Kenneth
It’s a pity there seem to be no participating hospitals in Scotland for the P3 trial. Best bet if either needs admission may be Ninewells, Dundee from the point of view of MAP access. Prof Chalmers is the Covid guru there. Meantime, in addition to breathing exercises, they should definitely be taking Vitamin D and Zinc supplements. Dr Fauci allegedly takes 6000 IU of the former as prophylaxis. In addition, perhaps more contentiously, you should check out Nigella seeds and honey as natural antivirals. One RCT last year suggested some beneficial effect. No personal experience but, in the absence of access to interferon. Maybe worth a try. Worth doing research on in any case. Hope things go well.
It’s an interesting choice of paper for a senior medical academic to write to. Not chosen by chance, for sure, but a thesis could be written on the factors influencing the choice.
“Does anyone know or believe if synairgen will rns the first patients dosed abroad, or can we safely assume that the full international phase 3 trial has started? “
This is just my personal view but I am not expecting to see 20 or so RNSs announcing first dosing in the participant countries. It is one study, unlike the large vaccine studies mounted and reported individually in different territories (eg Novavax).
Could it be the absence of any statement from NIH or information on the ACTIV website. The only “official” statement that I am aware of it our RNS, the accuracy of which I do not doubt. But it can’t have the same effect as confirmation from the trial sponsor will do when they get around to announcing it.
This would be an important consideration in a P3 home based study - eg ACTIV-2 -going forward. Hopefully not a big factor in the home arm of the SG016 study as the majority of cases would have been recruited before there was too much new variant around. It seems not to be much of a factor in hospital treated cases as the hospital case fatality is, so far, reported as being comparable in new and old variant disease. Nevertheless something the statisticians will be looking out for.
Lock-in
I would be very disappointed if they hadn’t. In the Uk at least. But if you learn that one centre - doesn’t have to be Hull - is recruiting at the rate of n cases per week it gives you the basis to extrapolate to what might be happening overall and what we might be looking at in timescales - weeks or months.
Information on a lady who happened to be first patient recruited is not really useful. I wouldn’t be interested in any attempt to invade her privacy in any case. Ok, I know that she agreed to be on tv etc but she is still entitled to privacy now. But, if people have contacts in the Hull hospital, it would be useful to know the rate at which people are being recruited to the study. One a day or even every other day would be a very promising start. None since Ms Constantin, not so good.
Theboyg: “ The Q2 was ridiculous timing! Results in. Country in full lock down! ”
Calm down! Last patient last visit in 4 weeks time so the clock doesn’t start until then. Results of the first leg of SG016 were published on 20 July last year 3 weeks after LPLV. That’s the appropriate benchmark here. That means mid March. No earlier, possibly a little later.
Based on form, I would say, yes.
Southampton, UK - 28 May 2020: Synairgen plc (LSE: SNG), the respiratory drug discovery and development company, is pleased to announce that recruitment of 100 hospitalised patients in its clinical trial of SNG001 (inhaled formulation of interferon-beta-1a) in COVID-19 patients has now been completed.
The health economic test for any intervention is quite a complex thing to compute but you can work wonders with the back of an envelope. For starters, you can’t think about it in terms of a single patient’s experience but in terms of the outcome in a population of treated individuals. So, at £2200 a pop, treating say 100 people would cost £220k. What you get for that spend is firstly the savings in other healthcare spend, secondly the improved health and/or death prevented as a result of the treatment, and thirdly the restored productive output (if any) of the individuals treated. This may be lower or nil in the case of economically inactive people like those who are retired. At £200-300 per day hospital costs or 4+ times that for ITU, even taking a crude and conservatively estimated average of £800 per day hospital costs and a mean reduction of hospital stay of 2 days you get a gross saving of £160k . And that is before you count the benefit conferred in terms of health on 100 people. Taking (hopefully) deaths prevented and chances of developing long Covid reduced you easily justify the residual £60k. One quality-adjusted life year (QALY) is currently valued at around £30k by health economists and national drug regulators in testing whether a drug represents value for money. Just conferring 2 additional years of life on just one of the 100 patients would be enough to “break-even” using these figures. Even if all of these numbers end up being a bit wide of the mark, and they are all more likely to be conservative than ambitious, the economic analysis is bound to come out in justification of this price in my opinion. At $3000 or £2200 per treatment course SNG001 is a no- brainer in value for money terms.
It means that there is a good chance that immunity conferred by vaccination OR BY PREVIOUS INFECTION WITH THE EARLIER STRAIN(S) of the vaccine won’t work against the new strain. So, we go straight down a snake to square 1. Yes it will be possible to re-jig the vaccines but this takes development, production and roll-out time.
Zephi, the world has been playing catch-up with the SARS-COV 2 virus for a year now and, despite the emergence of a plethora of vaccines, is continuing to do so. Yes, high and repeated uptake of effective vaccines will control the spread of the disease to a large degree. Note the key words here: high, repeated, effective and control. This will not eradicate the virus and, like the flu virus it will duck and dive seeking emerging weak points in our defences. It is almost certain that there will be an ongoing incidence of cases for a very long time - working assumption: forever. Five percent of incident cases will be severe and require anti-viral treatment, many in hospital. State of the art treatment leaves much to be desired. It is to be believed that SNG001 offers a significant advance in treatment, perhaps reducing by 80% the number of patients requiring ventilation and promoting early and full recovery. So, if vaccination prevents the majority of people from contracting Covid, a minority of 7 billion people is still a lot of people who could stand to benefit from effective treatments, hopefully including SNG001. Hope this helps!
I tend to agree with DerbyCounter. Plenty of churn around current sp level until there is some real news. I think this will come much sooner than the scheduled completion date for P3 in the summer, though. If SNG001 is as effective as it is expected to be, this should should show through at interim evaluation and either the trial will be stopped or EUA implemented. A consideration might me drug availability. Startling efficacy and low availability is not a good look. In these circumstances, would EUA be withheld pending manufacture catch-up?