Doctors Question Trump's Experimental Covid Treatment and Dosage

Mish

To fight Covid, Trump took a large dose of an experimental drug made by Regeneron.

Serious Questions On Treatment

Please consider Science.Org's take on Antibody Treatment for COVID-19.

The article is confusing in that it discusses treatments by two different companies, Regeneron and Lily.

Here are a few snips regarding Regeneron.

James Crowe, a viroimmunologist at Vanderbilt University who is working with AstraZeneca to develop COVID-19 monoclonal antibodies, welcomed Regeneron’s detailed preliminary results. “I applaud Regeneron for releasing so much information,” Crowe says. “They’re contributing to public health by releasing this as soon as possible.” But he notes even people who did well on the monoclonal cocktail still had low levels of virus detectable after their treatment, which in theory could cause problems. “I was surprised that there was any virus at all given that these are such potent antibodies,” he says, adding that the residual virus detected in the swab tests may not be capable of copying itself.

Regeneron's trial had only 12 patients who had “COVID-19–related medically attended visits.” Although there was a trend toward more of these in the placebo group than treatment arms, only one was hospitalized.

Regeneron’s data raise difficult questions about when to use its cocktail. People who test positive for SARS-CoV-2 aren’t routinely screened for antibodies to it or for levels of the virus. “If the decision is going to be made to deploy such a therapeutic solution in the patients who might benefit the most and need it most, we’re going to have to solve the problem of using the right point-of-care diagnostic tools, either for serology or high viral load,” Yancopoulos said, noting that their partners—including Roche—are developing these types of assays.

Monoclonal antibodies are more difficult to make than many drugs and often are extremely expensive, which means that supply could outstrip demand and many countries might not be able to afford them. The U.S. government’s Operation Warp Speed has invested $450 million in Regeneron to produce up to 300,000 “doses” of its cocktail by the end of the year, which would be distributed to Americans free of charge.

Regeneron saw no difference between its low- and high-dose preparations used in the study. 

Key Details

  • Trump took a large doses even though they performed no better in tests.
  • The trial only had 12 patients who had “COVID-19–related medically attended visits.
  • Trump's Operation Warp Speed has invested $450 million in Regeneron

Statement from Regeneron

Please consider Regeneron Confirms that REGN-COV2 Antibody Cocktail Provided to  President Trump Under Compassionate Use Request.

Regeneron Pharmaceuticals, Inc. (NASDAQ: REGN) today confirmed that, as announced  by the White House Press Secretary, Regeneron provided a single 8 gram dose of REGNCOV2, a cocktail of two monoclonal antibodies, for use by President Trump. REGN-COV2 is an investigational COVID-19 therapy, which was provided in response to an Individual Patient Investigational New Drug (IND) application (commonly known as ‘compassionate  use’ request) from the President’s physicians.

Dose Questioned

Physicians Decided to Start Remdesivir Therapy for Trump

Bloomberg reports Physicians Decided to Start Remdesivir Therapy for Trump

Medical specialists have elected to start Remdesivir therapy for President Donald Trump, according to a tweet from Press Secretary Kayleigh McEnany that cites a statement from his physician.

Remdesivir is made by Gilead.

Remdesivir and COVID-19

Finally, please consider Remdesivir and COVID-19

In the first published placebo-controlled trial of remdesivir for treating severe COVID-19, Yeming Wang and colleagues were unable to attain their primary endpoint of time to clinical improvement. Although admittedly underpowered due to early trial termination, remdesivir did not appear to affect rates of severe acute respiratory syndrome coronavirus  (SARS-CoV-2) viral RNA load decline and mortality when compared with placebo. Given these disappointing findings, we are left to wonder if a lack of clinically significant outcomes in placebo-controlled trials could have been predicted. By inhibiting early coronavirus life cycle in vitro and in animal models, remdesivir might require initiation before the peak viral replication, which is not feasible in the clinical human presentation of COVID-19.

In cell cultures exposed to murine coronavirus, early remdesivir initiation substantially decreased viral titres compared with control. However, this treatment effect was completely lost when initiation occurred just 8 h after infection. In another study, mice administered early remdesivir relative to inoculation with SARS-CoV had substantially reduced lung damage compared with untreated cohorts, an effect that was lost when initiation was delayed by 2 days after inoculation. The need for early treatment has been identified in additional animal models, as Wang and colleagues confirm, with remdesivir initiation following peak viral replication being unable to affect disease severity or mortality.

The stories indicate Trump is on at least two distinct treatments. 

There are many COVID-19 Disease Treatments in various states of testing by Regeneron Pharmaceuticals, Mateon Therapeutics, Ely Lily, Innovation Pharmaceuticals, Sorrento Therapeutics, Algernon Pharmaceuticals,  Genentech, Humanigen, Inc., Eiger BioPharmaceuticals, FSD Pharma Inc. RedHill Biopharma Ltd, Corvus Pharmaceuticals, Organicell Regenerative Medicine, and others.

If you are confused, you are not the only one.

Mish

Comments (101)
No. 1-34
PecuniaNonOlet
PecuniaNonOlet

Why isnt trump demanding what he has been promoting: Hydroxychloroquine?

If trump is on that many drugs then somone must be really worried about his health.

30 days till election.
12 days till Boris Brexit Bonanza.
9 days for Trump to end up on ventilator?

Woodturner
Woodturner

What? No hydroxychloroquine? No bleach, no UV light? It’s the ultimate irony that the primary spreader of misinformation and downplaying Covid actually catches it. Though even for such a despicable person I can’t wish him ill. Though I’m sorely tempted.

Deedee43
Deedee43

He said he was taking it prophylactically months ago.....with zithromax. Don't know if he stayed on it though.

Dave_in_CT
Dave_in_CT

Maybe Trump's doctors should consider this: https://www.calcalistech.com/ctech/articles/0,7340,L-3852110,00.html

https://www.calcalistech.com/ctech/articles/0
Realist
Realist

I don’t see this as confusing at all. Trump is sick. He, and those around him, are demanding that the doctors “do something”. As a result, he has been hospitalized, and given anything that might possibly help him, as long as the risks appear acceptable. As far as hydroxychloroquine goes, supposedly he had already taken it to prevent catching COVID. That did not work. I am not sure if taking more of it now would help, but if the doctors thought it would, I am sure they would give it to him.

They also provided a list of what else he was taking: Vitamin D, Zinc, melatonin, aspirin, Famotidine (Pepcid).

The fact that they are not providing too much information at this point, makes it very difficult to guess at how he is doing. But given the rush to try “anything” possible, it appears that his condition is not very good.

In the meantime, a third Senator, Rob Johnson, of Michigan, has tested positive. More positives still to come.

Trump’s failure to properly respond to the virus, has hurt the nation badly. Now it has hurt those around him. Hopefully, he will recover, as will those recently diagnosed positive around him.

Augustthegreat
Augustthegreat

A friend of mine told me that tRump should try a disinfectant like Lysol which will wipe out all the virus.

Eddie_T
Eddie_T

They're using the shotgun approach, for sure. I wonder who exactly is making the decisions on his treatment.

Six000mileyear
Six000mileyear

Unless Trump dies from COVID, the public really doesn't know the truth of the medical situation. The follow-up treatment by an ineffective, experiment drug would allow him to claim he was "cured" without the health risks of unknown side effects.

Casual_Observer2020
Casual_Observer2020

I dont feel sorry for him or anyone else in this administration.

Sechel
Sechel

I'm suspicious of the timelines. The virus seems to have progressed too rapidly. Mu gut tells me Trump was infected far earlier. It would help if the white house told us the last time trump tested negative. There's a history of white houses down playing presidential illnesses. It's quite possible he's far sicker than being let on. The doctors should hold a press conference and lay it out

Doctors simply do not treat with experimental therapies for patients experiencing mild symptoms

Rbm
Rbm

Pence gets it Nancy is in charge

njbr
njbr

How's he doing?

Check the tweet count--4000 tweets/retweets this year already. But only one generic sort of tweet yesterday.

A bored guy with the sniffles could still work the thumbs.

njbr
njbr

WAPO---As Trump’s condition deteriorated during the day Friday, the president and his team ultimately made the decision to send him to Walter Reed preemptively — and, from a public relations perspective, when he was still able to walk to Marine One on his own, according to one outside adviser in frequent contact with White House officials. They feared the possibility of a further decline, and what that might mean, both for the president’s health and his political optics.

njbr
njbr

Vietnam
97,000,000 people
1096 total cases
35 total deaths
1 month without a case of community transmission

Let those numbers sink in.

And the guy who lead us down this disastrous road has now found that you cannot fudge the virus. It only took for him to get sick, not the couple hundred thousand dead in the US and the millions ill, and the unknown millions that will have their lives permanently changed.

US has 4% of the worlds population, but 20% of the worlds deaths and illnesses.

Elections have consequences.

Casual_Observer
Casual_Observer

As any doctor worth their medical degree will tell you, if you start taking medicines when you are not sick in the hopes of preventing illness, what happens is that when you do get sick, the virus is resistant to whatever you are taking. To me this explains the reason why they are giving stuff to Trump that is experimental. Covid-19 has probably adapted to his immune system because of the stuff he was already taking on and off and the stuff doctors would normally give just doesn't do anything because he was already taking it.

PecuniaNonOlet
PecuniaNonOlet

Why is it a national secret if Trump was on oxygen? Reporters asked Doctors if he was on oxygen on different days and the answer was always, “not today sir.”

Poor trump, gasping for breath....it’s just the flu....

Sechel
Sechel

Holy crap!

Doctors just said Trump was diagnosed 72 hours ago, Wednesday. This means Trump knowingly interacted with people knowing he was exposed and contagious. And people weren't social distancing or wearing masks.

Casual_Observer
Casual_Observer

Looks like Trump is improving rapidly based on today's report. No fever anymore. Now for the longer term consequences....

Casual_Observer
Casual_Observer

Trump's doctors try to downplay his condition, but blow up the timeline of Trump's illness

Donald Trump was flown to Walter Reed National Military Medical Center on Friday evening. At the time, he was apparently suffering from coughing, fever, lethargy, and some difficulty in breathing. The decision to send him to the hospital at that point appears to have been made not just out of an abundance of caution, but because, as The Washington Post reports, with Trump’s condition worsening, they wanted to move while Trump was “still able to walk to Marine One on his own.” Even at that point, they were concerned about the “political optics.”

On Saturday morning, Trump’s physician Dr. Sean Conley provided an update on his condition. Appearing 40 minutes late for a scheduled report, Conley said that Trump was “doing very well,” before introducing an entire team of specialists on respiratory and pulmonary care, along with infectious disease experts. Conley reported that Trump’s cough and nasal congestion were “resolving and improving.” Additional physicians reported that Trump was receiving “outstanding” and “state of the art” care—all of which is a world away from the crowded emergency rooms and hastily expanded ICUs faced by many COVID-19 patients. Conley indicated that Trump is receiving “the state of the art and beyond.”

One thing that immediately stood out—Conley said that it had been 72 hours since Trump’s diagnosis, which put that diagnosis well over a day earlier than anything revealed to the public. If Conley’s timeline is correct, Trump was already aware he was positive during a rally on Wednesday and a face-to-face fundraiser on Thursday.

Trump was said to no longer be running a fever. Conley refused to say how high Trump’s fever had been. Conley denied earlier statements that Trump had experienced breathing difficulty, saying that he had never had an issue with breathing. Asked about comorbidities, Conley described Trump as “slightly overweight” while insisting that his health was good.

The team confirmed that Trump had received both remdesivir and an experimental antibody treatment. Multiple attempts to get the doctors to respond to whether or not Trump had received oxygen were met with the answer “he’s not on oxygen right now” which is a pretty good indicator that Trump was given oxygen earlier. The longer reporters tried to get a straight answer, the more that Conley squirmed away from providing the information, but it seemed clear that Trump had received oxygen on Friday at the White House. Similarly, questions about Trump’s heart and lungs were met with answers that were more about the tests that Trump had received, than any results on those tests.

Conley refused to provide a date on which Trump last had a negative test, continuing to obscure the point at which he became infected and his status over the last week. The rapid decline of Trump’s condition is a strong indicator that he has actually been sick for several days. Considering that Trump is supposedly tested each day, this also suggests that the results of those tests may have indicated he was positive well before that information was released to the public—and at a point where Trump was still engaged in rallies and fundraising.

Previous reports indicated that Trump has received two treatments: antiviral drug remdesivir from pharmaceutical company Gilead Sciences, and monoclonal antibodies “cocktail” developed by Regeneron Pharmaceuticals.

Remdesivir emerged in May as a treatment which showed “a clear-cut, significant, positive effect in diminishing the time to recovery.” It’s been subject to an FDA Emergency Use Authorization for months, and has become widely used. There have been numerous studies about the use of the antiviral drug, and the best time in the infection for it to be administered. The drug remains expensive—over $3,000 for a single course of treatment—but it does seem to be effective for a significant percentage of COVID-19 patients and has been widely administered.

The monoclonal antibody treatment from Regeneron is something entirely different. It is not the subject of an EUA, and is supposed to be used only as part of restricted studies. At this point, there are only preliminary results from limited human trials. That preliminary data indicated that the treatment could reduce the viral load if administered early, before people develop their own antibody response to the virus. Generally, that means within the first week following exposure.

For Trump to receive this treatment involves invoking “compassionate use,” a decision that’s usually limited to patients in extremis. But since the treatment is best used soon after exposure, it’s unclear how compassionate use applies in this situation. Another unusual factor: Trump appears to have been given an injection an 8 gram infusion of the treatment, but the initial report from Regeneron specifically notes that a dose of 2.4 grams was just as effective. So why Trump was given such a large dose is unclear.

What’s not mentioned in discussion of Trump’s treatment is any sign that he’s been given hydroxychloroquine, much less been injected with either disinfectant or UV light. Trump’s treatment seems to reflect the best available medical advice at this point — including providing him with an experimental treatment that is decidedly not available to more than a handful of patients.

Jackula
Jackula

HCQ is for early, anti-viral. Ivermectin is looking real good as an anti-viral, better and safer than HCQ. His viral load is probably too high already for anti-virals. Counting from Wednesday when he first started feeling crappy if the case is gonna be a bad one we'll know by next Friday or so. Everybody I know that had a bad case got bad about day 9 or so.

njbr
njbr

Mark Meadows is source....Doctors involved in the President’s treatment have sought to paint a rosy view on President Trump’s recovery, telling reporters on Saturday that Trump was doing “very well.”

But a source familiar with the president’s health said that Trump’s vitals over the last 24 hours were “very concerning,” according to a White House pool report, and that the next 48 hours will be critical in terms of his care. “We’re still not on a clear path to a full recovery,” the source said.

njbr
njbr

Again--look at his tweet traffic.

A case of sniffles doesn't stop your thumbs from working....

Casual_Observer
Casual_Observer

AP UPDATE as of 11 minutes ago:

According to a person familiar with Trump’s condition, some of Trump’s vital signs over the past 24 hours were “very concerning.” The person, who was not authorized to speak publicly and spoke to The Associated Press on condition of anonymity, said the next 48 hours will be critical in terms of his care.

RonJ
RonJ

You didn't mention zinc. KTLA "News" reported that last night.

mrutkaus
mrutkaus

He asked for a Yuuugh dose!

Kimo
Kimo

Zinc & Vit D were used. Apparently enough to turn this bad situation around. Lots of pointless questions about hospital admission and oxygen, but no reporter ask about HCQ, and why it was not used. Doctors say he is fine, unnamed source says he's not. Guess which one is the conspiracy theory. I say he is out on Monday, self quarantined for another 10 days. Twitter storm, not cytokine storm.

ColoradoAccountant
ColoradoAccountant

An older post explained that it is zinc that defeats the virus, but it can't get to the virus on its own and piggy backs on HCQ for transport.

Sechel
Sechel

On CNN. Use of Remdesivir means Trump most likely had abnormal chest xray and impaired breathing....

More promising results come from a large National Institutes of Health (NIH) study that enrolled over 1,000 hospitalized COVID-19 patients across 22 countries. To qualify, patients had to be hospitalized with confirmed COVID-19 and have evidence of lung involvement, such as an abnormal chest X-ray or needing supplemental oxygen.

kram
kram

Yes. And it works best when administered early, perhaps as soon as the diagnosis is made. It may not be so effective when the viral load increases and the disease locks on.

Jojo
Jojo

Wonder if they have tried this?

Budesonide for CV19

Sechel
Sechel

highly edited. @ 1.04 they edited out a cough. the papers he's signing are also blank

angin elle lapun
angin elle lapun

I come from a Pacific Island nation called Papua New Guinea. My country shares borders with Indonesia, Australia and Solomon Islands..I usual search on Youtube any interesting documentaries. Whilst looking up youtube videos I came across a documentary on people who suffer ALS and their real treatment from www.multivitamincare.org. I for had never heard of this crippling and debilitating disease affecting a lot of Americans. It is very torturous to watch and hear patients who suffer. It is more like a combination of various diseases all put into one. Like a person who has suffered a stroke, plus someone suddenly becoming paralysed, cancer etc. but I also get to know understand that there has been successful cure to this disease from multivitamin care. It is too much for a patient to endure such as they slowly begin to pass away if the right medication is not taken .Having a positive mind is a powerful tool .My prayers goes out to ALS patients and their care givers.


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