Alexion is investigating monoclonal antibody treatments Soliris (eculizumab) and Ultomiris (ravulizumab-cwvz) as potential therapeutics for COVID-19. While these drugs have established safety data, they both have prophylactic antibiotic administration requirements to prevent meningococcal disease during treatment.

Johanna Swanson, Product Manager at GlobalData, comments: “Both of these drugs are expensive at $500,000 and $458,000 a year in the US, and require IV administration, which may be prohibitive. Administration in a hospital setting is also required, which increases the cost of treatment. The drugs could, therefore, see issues with reimbursement and patient access for COVID-19.”

As FDA-approved treatments for paroxysmal nocturnal hemoglobinuria, Alexion considered these drugs for the treatment of COVID-19 based on a ‘preclinical scientific rationale’ that supported the drug’s use for patients with severe pneumonia or acute respiratory distress syndrome (ARDS).

Swanson continues, “These drugs both have Advisory Committee on Immunization Practices (ACIP) guidelines to vaccinate for meningococcal disease two weeks before treatment begins. For the clinical trials, co-administration of a prophylactic antibiotic for meningococcal disease is required unless the patient has a previous meningococcal vaccination. This could also increase the cost of treatment.

“However, these treatments have positives too – they are both already marketed, with established safety data, and are known to detune a specific part of the immune system, which may exacerbate viral infection. In addition, they could be used in combination with antivirals and supportive care, and if found to be effective, they could be the first COVID-19 treatment to market and could be available shortly after clinical studies complete.”