Eric Topol Profile picture
Oct 2, 2020 8 tweets 7 min read Read on X
Some comments on treating w/ the @Regeneron monoclonal antibody infusion.
1. @statnews piece by @matthewherper statnews.com/2020/09/29/reg…
and company press release with more extensive data
The viral load clearing effects were related to being antibody negative
2. The dose given (8 g) was the highest tested. There were also non-human primate studies.
Here is the main paper @ScienceMagazine rationale for the "cocktail" as compared to a single monoclonal for the other antibody programs.
science.sciencemag.org/content/369/65…
3. Here are the prophylaxis and treatment data preprint in macaques and hamsters
biorxiv.org/content/10.110…
4. A balanced status check from a few days ago washingtonpost.com/health/2020/09… by @Carolynyjohnson
5. That's the summary of the data set for this experimental therapy. So far safety has not been a stumbling block. But what isn't known is the indication for using it today as "precautionary." Still many unknowns about the mAbs, too.
6. BTW both companies (@LillyPad and @Regeneron) with release of their small Phase 2 trials have asserted they have enough data to apply for an FDA emergency use authorization. I disagree, but that's a different matter.
7. @Regeneron's note today on their compassionate use program
investor.regeneron.com/static-files/f…
That's not really a clinical trial. It's an open use of drug w/o controls, provides some safety data. Would be interesting to learn how many patients received the mAb to date in this program.
8. Now Len Schleifer, CEO of @Regeneron on @CNN talking w/ @wolfblitzer. Justifying it as a "fair fight" for boosting immune response. Also doesn't comment on ? of possible infusion of the mAb to @FLOTUS

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More from @EricTopol

Jul 21
The new boosters (vs. KP.2) should be available the first week of September. It takes ~90 days make them from the FDA decision on June.

But it didn't have to be that way.......1/5nbcnews.com/health/health-…
We've known about KP.3's marked growth advantage since April and could have made the call then to make the new booster. That would have been aligned well with the current wave (available in July) 2/5 erictopol.substack.com/p/are-we-flirt…
Image
But the FDA has tried to force fit Covid into an annual shot like flu, even though all data tells us it doesn't follow an annual pattern. Even the CDC acknowledges this now
3/5cdc.gov/ncird/whats-ne…
Read 5 tweets
Jun 21
New CDC genomic data shows continued rise of the KP.3 variant that accounts for 1 of 3 Covid cases.
LB.1 is gaining, too, as JN.1 fades away Image
This variant growth advantage plot by @BenjMurrell (H/T @siamosolocani) shows why this is the case. Note KP.3 is the one at far left w/ almost 3-fold advantage to JN.1.
Reinforces why the decision to develop the KP.2 vaccine booster (instead of JN.1) was a good one Image
Spike mutation map to show the differences betweem KP.3 and JN.1 (and LB.1, KP.2) Image
Read 4 tweets
May 16
The connection between #SARSCoV2 and neurodegeneration
@TheLancetNeuro
Quotes below:
1. SARS-CoV-2 infection should be considered as a risk factor for Alzheimer’s disease, even though the distinction between causation versus disease acceleration is not clear.thelancet.com/journals/laneu…Image
2. Inflammation in patients with COVID-19, and controlled experiments show prolonged neuro-inflammation after mild SARS-CoV-2 infection
in macaques.
3. A direct correlation has been reported
between prior SARS-CoV-2 infection and increased risk
of Alzheimer’s disease (figure).

4. So far, the estimated lifetime cumulative risk of dementia due to hospitalisation for any viral infection is 1·48 (95% CI 1·15–1·91).
Read 5 tweets
Apr 26
The FLiRT variant KP.2 begins its takeover for Covid cases in the US, now accounting for 1 in 4 cases
covid.cdc.gov/covid-data-tra…
Image
I've reviewed the FLiRT variants and their implications in a Ground Truths (link in profile) Image
The 2 mutations in the spike that account for KP.2's rise to dominance, compared with the JN.1 variant which has prevailed for months Image
Read 5 tweets
Jan 22
Breaking down the risks and benefit for lecanemab, the amyloid beta-directed antibody vs Alzheimer's drug approved @US_FDA last year. It doesn't look good.

@AnnalsofIM acpjournals.org/doi/10.7326/M2…
Image
A new systematic review of these antibodies looks even worse @AnnFamMed doi.org/10.1370/afm.30…



Image
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Fixed link for this important paper
annfammed.org/content/22/1/5…
Read 4 tweets
Jan 4
My oped on the JN.1 variant and the 2nd biggest US wave of infections (after Omicron) since the pandemic began
@latimes @latimesopinion #LongCovid latimes.com/opinion/story/…
Image
Recent @CDCgov #SARSCoV2 wastewater data for current wave (vs Omicron Jan 2022 and subsequent waves), graph by @luckytran Image
Sorry, @washingtonpost, but this is not "another Covid-19 uptick" as you put it in your Health Alert. You ignore the best metric for infections that we have at present—wastewater—focusing only on hospitalizations
washingtonpost.com/health/2024/01…
Image
Read 4 tweets

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