(09-17-2020, 09:57 AM)BostonCard Wrote: Quote:These biomarker data correlated with LY-CoV555's positive impact on the prespecified endpoint of COVID-19-related hospitalization or ER visit. This endpoint occurred in 1.7 percent (5/302) of LY-CoV555 patients, pooled across dose groups, as compared to 6 percent (9/150) of placebo patients, which corresponds to a 72 percent risk reduction in this limited population.
The numbers are small and the confidence interval is wide, but if you used the point estimate, you would need to treat 23 patients with COVID-19 to prevent one COVID-19-related hospitalization on ER visit. Whether it is worth it might depend on whether most of those are hospitalizations or ER visits.
BC
Indeed this is another example of the "relative benefit" making a treatment look more useful than it actually is. Since only 6% of the control group was hospitalized, you would need to treat a lot of people to have any real benefit (1 in 23). Obviously the ability to do that depends greatly on the cost of the therapy, which we don't know. It may be that a sub-fraction of the subjects benefited more significantly, like possibly the people over 50 years old. The phase 2 study probably isn't large enough for this kind of analysis, so we won't know for a while.
I would also assume that there is a trial going on with patients that are already hospitalized. In those cases lowering the virus titers is only part of the story. The immune system response, secondary infections and a host of other things also become factors. That said, it is not unreasonable to expect that the ability to drive down the virus titers while still suppressing an over-active immune system would be very useful.
An obvious possibility for improvement in effectiveness would be obtained if the ability to predict who would require hospitalization was available. In the clinical trial this was not attempted. I am sure that in the "real world" there is some ability to do this, but in the absence of any real treatment being available it probably hasn't been a priority. If there is an effective treatment available even a modest improvement in predicting who should receive it would be a big force multiplier.