Eli Lilly’s Neutralizing Antibody Therapy for COVID-19 Reduces Hospitalization Rates in Phase 2 Clinical Trial

A SARS-CoV-2 neutralizing antibody from Eli Lilly and Company (Indianapolis, Ind, USA) has been found to reduce hospitalization rates among COVID-19 patients in a Phase 2 clinical trial.

Lilly has announced proof of concept data from an interim analysis of the BLAZE-1 clinical trial, showing a reduced rate of hospitalization for patients treated with LY-CoV555, a SARS-CoV-2 neutralizing antibody. The randomized, double-blind, placebo-controlled Phase 2 study evaluated LY-CoV555 for the treatment of symptomatic COVID-19 in the outpatient setting. The trial enrolled mild-to-moderate recently diagnosed COVID-19 patients across four groups (placebo, 700 mg, 2800 mg, and 7000 mg).

The pre-specified primary endpoint, change from baseline in viral load at day 11, was met at the 2800 mg dose level, but not the others. Most patients, including those receiving placebo, demonstrated near complete viral clearance by day 11. Additional analyses of viral data demonstrated that LY-CoV555 improved viral clearance at an earlier time point (day 3) and reduced the proportion of patients with persistently high viral load at later time points.

These biomarker data correlated with LY-CoV555's positive impact on the pre-specified endpoint of COVID-19-related hospitalization or ER visit. This endpoint occurred in 1.7% (5/302) of LY-CoV555 patients, pooled across dose groups, as compared to 6% (9/150) of placebo patients, which corresponds to a 72% risk reduction in this limited population. Most study hospitalizations occurred in patients with underlying risk factors (age or BMI), suggesting a more pronounced treatment effect for patients in these higher-risk groups. Across all treatment groups (including placebo), no patients progressed to mechanical ventilation or died. Exploratory analyses indicated a more rapid improvement in symptoms for patients treated with LY-CoV555 versus placebo, supporting the hospitalization effect.

LY-CoV555 was well-tolerated, with no drug-related serious adverse events reported. Treatment emergent adverse events were similar across all dose groups and comparable to placebo. Viral RNA sequencing revealed putative LY-CoV555-resistance variants in placebo and all treatment arms. The rate of resistance variants was numerically higher in treated patients (8%) versus placebo (6%).

Lilly intends to quickly publish the results of this interim analysis in a peer-reviewed journal and discuss appropriate next steps with global regulators. The BLAZE-1 clinical trial remains ongoing, testing LY-CoV555 in combination with a second Lilly antibody, LY-CoV016, which binds a different epitope in the SARS-CoV-2 spike region. The trial is currently enrolling a larger, confirmatory cohort of higher risk patients, testing the ability of the antibody combination to reduce the number of patients with persistently high viral load and reduce COVID-related hospitalizations.

"These interim data from the BLAZE-1 trial suggest that LY-CoV555, an antibody specifically directed against SARS-CoV-2, has a direct antiviral effect and may reduce COVID-related hospitalizations," said Daniel Skovronsky, M.D., Ph.D., Lilly's chief scientific officer and president of Lilly Research Laboratories. "The results reinforce our conviction that neutralizing antibodies can help in the fight against COVID-19."

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