Candidates: Prezista® (darunavir); Prezcobix™ (darunavir and cobicistat)
Types: HIV-1 protease inhibitor (darunavir); CYP3A inhibitor (cobicistat). Prezista and Prezcobix are approved treatments for HIV-1 infection.
Status: Johnson & Johnson confirmed March 16 that it was screening its marketed HIV treatment Prezista and other antiviral compounds to determine potential in vitro effect against SARS-CoV-2—and decried “anecdotal, unsubstantiated reports” that Prezista has antiviral effect against COVID-19. J&J emphasized that the drug “should not be administered without a boosting agent (ritonavir or cobicistat).”
The company cited preliminary, unpublished results from a previously reported in-vitro experiment in asserting: “it is not likely [Prezista] will have significant activity against SARS-CoV-2 when administered at the approved safe and efficacious dose for the treatment of HIV-1 infection.” The company also cited results from a single center, open label, randomized, and controlled trial conducted at Shanghai Public Health Clinical Center of Prezista and cobicistat in treating laboratory-confirmed 30 COVID-19 patients, which it said showed that the combination was not effective.
Janssen said in January it donated 300 boxes of Prezcobix to the Shanghai Public Health Clinical Center and Zhongnan Hospital of Wuhan University for use in research to support efforts in finding a solution against SARS-CoV-2. Another 50 boxes were provided to the Chinese Center for Disease Control and Prevention for laboratory-based investigations. Prezcobix is under study alone in one Chinese trial (NCT04252274), while another Chinese study is assessing Prezcobix compared with Kaletra (lopinavir/ritonavir) combined with thymosin a1 (ChiCTR2000029541). A Spanish trial is evaluating Prezcobix and chloroquine (NCT04304053), while a trial in Bangkok is assessing Prezcobix among numerous HIV protease inhibitors (THDMS-COVID19; NCT04303299).
COVID-19: 200 Candidates and Counting
To navigate through the >200 potential therapeutic and vaccine options for COVID-19, GEN has grouped the candidates into four broad categories based on their developmental and (where applicable) clinical progress:
● FRONT RUNNER – the most promising therapeutics/vaccines based on clinical progress, favorable data or both.
● DEFINITELY MAYBE – earlier phases with promising partners, or more advanced candidates in development that have generated uneven data
● KEEPING AN EYE ON… – interesting technology, attracting notable partners, or both, but preliminary data.
● TOO SOON TO TELL – longshots pending additional experimental and/or clinical data.
GEN has also tagged the most common treatment types: