BioPharma, Policy

Amid mixed messages about his Covid-19 diagnosis, Trump looks like a one-man clinical trial

While the White House and doctors at Walter Reed have sought to reassure the public that Trump’s condition is improving, he has received numerous drugs for Covid-19, including the steroid dexamethasone, which is typically administered only to those who are critically ill.

About the only thing anyone can state definitively about President Donald Trump’s health is that it’s, well, confusing.

After disclosing on Twitter early Friday morning that he and First Lady Melania Trump had tested positive for Covid-19, the president was transferred to Walter Reed National Military Medical Center “out of an abundance of caution.” Yet, despite claims that he was improving and could be discharged as early as Monday, it was also reported that Trump had taken dexamethasone for the disease, which was characterized by Mark Meadows, the chief of staff, as being more severe than previously reported. Meanwhile, he also staged a widely panned photo op Sunday in which he drove past and waved to supporters in a hermetically sealed bulletproof presidential SUV, a move that experts said had put his own Secret Service agents at risk for contracting the coronavirus.

What sticks out about dexamethasone, a decades-old steroid drug, is that it is under an emergency use authorization from the Food and Drug Administration for Covid-19, in particular to tamp down the severe inflammatory responses associated with the most severe cases, but it is not typically used in patients with mild to moderate disease.

And it’s not the only drug for Covid-19 that Trump has taken. Initially, he received Regeneron Pharmaceuticals’ experimental drug REGN-COV2, a two-antibody antiviral cocktail designed to target two areas of the spike protein of the SARS-CoV-2 virus in order to inhibit its ability to evade the immune system. However, that drug is still being tested in clinical trials and, despite data indicating efficacy, it has not yet received an EUA or approval. Trump then received Gilead Sciences’ Veklury (remdesivir), which is administered over a five-day period.

Last week, Tarrytown, New York-based Regeneron said data showed that patients in its Phase I/II/III trial who received REGN-COV2 had lower viral loads and faster alleviation of symptoms than those who received placebo and that it planned to take the data to regulators. Meanwhile, Gilead said it was meeting real-time supply demands for Veklury and would take over distribution of the drug in the U.S. from the federal government.

As of Monday, more than 7.4 million Americans had been infected with the coronavirus, and more than 209,000 had died.

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A Deep-dive Into Specialty Pharma

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