New analyses of two AZD7442 COVID-19 phase-III trials in high-risk populations confirm robust efficacy and long-term prevention

AstraZeneca yesterday said that new data from the AZD7442 COVID-19 Provent prevention and Tackle outpatient treatment phase-III trials showed robust efficacy from a one-time intramuscular (IM) dose of the long-acting antibody (LAAB) combination.

The company, via a statement, also said that in an analysis of the ongoing Provent trial evaluating a median six months of participant follow-up, one 300mg IM dose of AZD7442 reduced the risk of developing symptomatic COVID-19 compared to placebo by 83 per cent.

About two per cent of the global population is considered at increased risk of an inadequate response to a COVID-19 vaccine. This includes people with blood cancers or other cancers being treated with chemotherapy, patients on dialysis, those taking medications after an organ transplant or who are taking immuno-suppressive drugs for conditions including multiple sclerosis and rheumatoid arthritis, it added.

According to the statement, The AZD7442 Provent trial is the first phase-III trial prospectively designed to evaluate a monoclonal antibody for pre-exposure prophylaxis of symptomatic COVID-19, with targeted inclusion of high-risk and immunocompromised participants. More than 75 per cent of Provent participants at baseline had comorbidities that put them at high risk for severe COVID-19 if they were to become infected, including people who are immunocompromised and may have a reduced immune response to vaccination.

Further, there were no cases of severe COVID-19 or COVID-19-related deaths in those treated with  AZD7442 at either the primary or six-month analyses. In the placebo arm, there were two additional cases of severe COVID-19 at the six-month assessment, for a total of five cases of severe COVID-19 and two COVID-related deaths, the statement mentioned.

It also said that an exploratory analysis of the Tackle outpatient treatment trial, in patients with mild-to-moderate COVID-19, showed that one 600mg IM dose of AZD7442 reduced the risk of developing severe COVID-19 or death (from any cause) by 88 per cent compared to placebo in patients who had been symptomatic for three days or less at the time of treatment.

A total of 90 per cent of participants enrolled in TACKLE were from populations at high risk of progression to severe COVID-19 if they became infected, including those with co-morbidities. In both Provent and Tackle, AZD7442 was generally well-tolerated. No new safety issues were identified in the six-month analysis of Provent, as per the statement.

Speaking in this regard, Hugh Montgomery, Professor, Intensive Care Medicine, University College London, the UK and AZD7442 principal investigator, said, “These compelling results give me confidence that this long-acting antibody combination can provide my vulnerable patients with the long-lasting protection they urgently need to finally return to their everyday lives. Importantly, six months of protection was maintained despite the surge of the Delta variant among these high-risk participants who may not respond adequately to vaccination.”

Adding to it, Mene Pangalos, Executive Vice President, BioPharmaceuticals R&D, AstraZeneca, said, “AZD7442 is the only long-acting antibody with phase-III data to demonstrate benefit in both pre-exposure prophylaxis and treatment of COVID-19 with one dose. These new data add to the growing body of evidence supporting AZD7442’s potential to make a significant difference in the prevention and treatment of COVID-19. We are progressing regulatory filings around the world and look forward to providing an important new option against SARS-CoV-2 as quickly as possible.”

The statement notified that results from Provent and Tackle will be submitted for publication in a peer-reviewed medical journal and presented at a forthcoming medical meeting.

On 5th October, 2021, the company announced that it had submitted a request to the US Food and Drug Administration (FDA) for Emergency Use Authorisation (EUA) for AZD7442 for prophylaxis of COVID-19. AstraZeneca has agreed to supply the US Government with 700,000 doses of AZD7442 if granted an EUA by the FDA, and has agreements to supply to other countries, the statement concluded.