RE: Reminder14 Dec 2020 05:19
That's the $64 billion dollar question. You can find any number of leading professionals who will repeat that - "it needs to be given early". It's become a sort of received wisdom, repeated in several key papers. AFAIK it comes from concern that beta interferon (a cytokine) might exacerbate cytokine storms in the late stages. It's actually why we wanted to do a home trial in the first place.
However - the P2 data said otherwise. They were giving it to patients 10 days after symptoms appeared and it still worked.
There are a few hypotheses as to why, an interesting paper recently suggested that lung cells react differently to beta interferon than I think it was liver cells - specifically the ACE2 regulatory response. Fascinating stuff, I think it sort of makes evolutionary sense in allowing an immune response without immediately inflaming the lungs. Or another line of thought about 3 months ago was that there is in fact no cytokine storm and instead a 'Bradykinin' storm, which beta interferon would not exacerbate. I don't think that's prevalent now but I haven't seen it conclusively ruled out.
Anyway - P3 should answer this question and it will be new science - an idea widely held to be true may be disproved. Sorry to ramp slightly but whatever happens with covid in the short term (and it's crazy to discount covid, which has not gone away) the company has the potential to deliver a therapy which changes respiratory medicine forever.
We're just in the slightly awkward phase of standing around feeling a bit useless while they give birth.
Meanwhile the argument over how hard they should be pushing has escalated to a punch-up in the car park :)