A couple of points that may not have been mentioned on other threads.
There is a recent study out of Taiwan that reviewed millions of health records across the entire country looking for side effects from a short course of corticosteroids, such as Dexamethasone at the dose/duration being used for C-19 patients requiring oxygen supplementation or mechanical ventilation. The study found a surprisingly high incidence of serious adverse events (GI bleeding, sepsis, heart failure) even in otherwise healthy patients with no pre-disposing co-morbidities. So, this may temper use a bit in C-19 patients who might be at even greater risk of adverse events. A summary of the study is here:
http://www.acpinternist.org/weekly/archives/2020/07/07/2.htmAs we all know, Regeneron received a sizable grant from the US government to further develop 2 mAb's directed at spike proteins of the SARS-Cov-2 virus, which is the causative agent of C-19. These types of antibodies did not appear on my May 21 list of potential competitors, and they should be distinguished from mAbs directed against cytokines or cell receptors involved in so-called "cytokine storm", several of which did appear on my list. I don't consider the former type of antibody to be direct competitors to remestemcel-L, though some observers on this board may disagree. They fall into the same realm as "convalescent plasma", which also contains antibodies directed against the virus itself. In other words, they are a form of passive immunity if used for prophylaxis, or they may be thought of as an "anti-viral" when used as therapy..... I don't consider vaccines and anti-virals to be competitors as I outlined in my first post. Vaccines provide "acitve immunity" and don't always work (or are not taken). I suspect "passive immunity" will also fail, or not get used, or cause side effects in any number of cases. And of course passive immune efficacy wanes after a couple of months and must be restored with a new injection. So, these antibodies may lower the overall number of C-19 cases - and that's good for all of us. But I doubt they will snatch ICU patients away from rem-L. And they will not of course treat other causes of ARDS or reverse fibrosis.
Meanwhile, Regeneron is not the only company working on this approach. Eli Lilly is also developing an anti-SARS-Cov-2 mAb labeled
LY-CoV555. And a company that did appear on my May 21 list, Biohaven, is an investor in Kleo Pharmaceuticals, a small biotech working on a monoclonal antibody approach to the virus itself. Today Kleo announced a $5M grant from the Gates Foundation to develop a mAb paired with a "monoclonal antibody therapy enhancer". You can read about it here:
http://www.globenewswire.com/news-release/2020/07/08/2059184/0/en/Kleo-Pharmaceuticals-Announces-5-Million-Grant-to-Advance-Development-of-COVID-19-Hyperimmune-Globulin-Mimic-HGM-as-a-Therapeutic-for-Infected-Patients.htmlMy investment thesis for Mesoblast and C-19 remains unchanged by all of this, if not strengthened. Covid-19 is a widespread complex illness attacking patients with a variety of differing co-morbidities. No one approach will work for every patient and no one company is in a position to take on the entire world. From an investment viewpoint C-19 is an "extra" for Mesoblast that fell from the sky just a few months ago. As with influenza where we have vaccines and anti-virals, some patients still fall critically ill from the virus. Even if vaccines, anti-virals and passive immunizations prove successful in say 95% of C-19 cases, a "medicine of last resort" will still be needed in the ICU for the hundreds, even thousands, that manage to slip by. History and other viral illnesses teach us that there will continue to be plenty of cases for such a medication to rescue. We need a vaccine... we need passive immunity... we need anti-virals... and we need highly effective therapeutics for those who fail on the first three. Enter remestemcel-L, still the most promising in that latter category. Waiting for news, glta
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