Pfizer dominates the COVID drug market. This biotech in Watertown wants to change that. – Boston Globe

Pfizer dominates the COVID drug market. This biotech in Watertown wants to change that. – Boston Globe

“COVID is not going to go away,” he said. “We wanted to design something better, because we knew we wouldn’t be the first.”

Enanta is among a shrinking group of companies still testing experimental COVID pills. Japanese drugmaker Shionogi and California-based Pardes Biosciences are testing COVID pills in advanced and intermediate stages, respectively. those It could also be a direct competitor to Paxlovid. And Boston-based Atea Pharmaceuticals is in advanced stages of testing for a COVID-19 antiviral that could expand options for doctors and patients.

“We need alternatives to baxlovid,” said Dr. Melanie Thompson, an HIV physician and clinical researcher at a private practice in Atlanta. “I think these drugs that are in development now will find a market, because we’re still getting deaths from COVID and some people are still not getting vaccinated.”

Enanta’s phase 2 trial — called SPRINT — is enrolling about 200 adults with mild or moderate COVID-19 who do not require hospitalization. Each participant will receive an Enanta pill or a placebo for five days. The company expects to share data from the study in the first half of 2023.

Paxlovid is approved for use in the treatment of mild to moderate COVID-19 in adults and children 12 years of age and older. Kalpana Gupta, chief of staff and chief of infectious diseases at the VA Boston Healthcare System, said the drug “helped keep patients out of the hospital.” But she added that some people cannot take the drug because it can cause harmful interactions when taken with many other medications, including some blood thinners, epilepsy medications, and treatments used to prevent abnormal heart rhythms.

The reason for these safety concerns is an HIV drug called ritonavir, which is one of two compounds in baxilvid that are included to help slow the metabolism of the second compound, nirmatilvir, which disrupts the coronavirus’s ability to properly process its genome and limits its replication. .

Dosages of the antiviral drug baxlovid are shown in New York on Monday, August 1, 2022. Stephanie Nano/The Associated Press

Sacks, clinical director of the division of infectious diseases at Brigham and Women’s Hospital: “There’s a very long list of medications that are difficult to use with baxlovid.” “And the people most at risk of severe COVID-19 are also people with multiple comorbidities.”

Enanta’s drug, called EDP-235, targets coronavirus proteases without the need for ritonavir. “Physicians will have to spend a lot less bandwidth figuring out what to do with the patient,” Lully said.

Watertown’s birth control pills are also designed to be taken once a day, rather than twice a day like Paxlovid. As an added bonus, Lully said, it doesn’t taste as bad as a Pfizer pill.

“It seems to have some very positive characteristics,” Thompson said. But she cautioned that the company would eventually need to run a larger clinical trial to prove its efficacy.

Enanta will follow patients for four weeks, so it should be able to tell if people have rebound infection — a problem that has plagued baxiloid. Lully said previous studies with Enanta suggest it’s best to get to the crevices of the body where coronaviruses can hide, which could increase the potential for preventing the rebounds seen with baxiloid.

Luley said that unlike the coronavirus’s spike protein – which is what most antibodies target – the protease didn’t change much across SARS-CoV-2 variants. “And part of the reason for that is because viruses use this enzyme to replicate themselves, so they can’t tamper with that enzyme too much for their own good,” he said. He expects Enanta to continue to be effective for future variants.

Infectious disease doctors are encouraged that companies are still developing COVID drugs that should continue to operate even if the virus evades immunity from vaccines.

“The COVID antiviral pills are still going strong against the current variants, which is really cool,” Gupta said. “So it makes a lot of sense to work on something that will remain less vulnerable to new changes.”

“I think these drugs will be a game changer in terms of learning to live with COVID-19 and allowing people to resume their normal lives,” she added. “So I’m glad to see more on the horizon.”

Ryan Cross can be reached at ryan.cross@globe.com. Follow him on Twitter Tweet embed.

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