Our Tuesday Pick...Drug Discovery Guy Derek Lowe.

ExpertsAndHonestBrokers
StillMatterVille


Derek Lowe's 'In The Pipeline' blog has been over there on the left-side, post-rolling thingy for awhile now.

But, until I did a little digging, I had no idea that Lowe has been blogging since the dinosaur times (i.e. 2002).

As for his scientific work in the actual drug discovery field, well, he's been at that for even longer, given his PhD from Duke that was followed by significant stints at Vertex, Bayer, Schering-Plough and Novartis.

All of which, of course, makes him suspect for some who have an issue with big pharma.

Personally, as a science geek of a certain bent I've had enough tangential interactions with such entities over the years to always be wary of their intentions, particularly from a 'business' point of view. They are corporations after all.

However, I've never had any issues with the scientists in the trenches.

Regardless, in the years that I've been following Mr. Lowe's blogging I've found him to be a knowledgeable and insightful honest broker on anything he covers.

And lately he's been doing a bang-up job covering the development of potential COVID-19 intervention strategies.

Additionally, he can also really write, which means that you don't have to be in the game to understand what he has to say.

The following snippets are from a recent post titled 'What's happening with Remdesivir?' that I wish every broadcast and print media outlet with any reach at all would refer to every time some imbecile says something stupid regardless said imbecile's point of view:

Well, everyone was just dealing with the news that Gilead’s antiviral remdesivir had had two trials suspended in China, when Stat‘s Adam Feuerstein and Matthew Herper broke news last night about a trial here in the US....

{snip}

...(N)ow that it’s out there, let’s talk about what’s in the leak. Gilead stock jumped like a spawning salmon in after-market trading on this, and one of the reasons was that that 113 of the 125 patients were classed as having “severe disease”. People ran with the idea that these must have been people on ventilators who were walking out of the hospital, but that is not the case. As AndyBiotech pointed out on Twitter, all you had to do was read the trial’s exclusion criteria: patients were not even admitted into the trial if they were on mechanical ventilation. Some will have moved on to ventilation during the trial, but we don’t know how many (the trial protocol has these in a separate group).

Note also that this trial is open-label; both doctors and patients know who is getting what, and note the really key point: there is no control arm. This is one of the trials mentioned in this post on small-molecule therapies as being the most likely to read out first, but it’s always been clear that the tradeoff for that speed is rigor. The observational paper that was published on remdesivir in the NEJM had no controls either, of course, and that made it hard to interpret. Scratch that, it made it impossible to interpret. It will likely be the same with this trial – the comparison is between a five-day course of remdesivir and a ten-day course, and the primary endpoint is the odds ratio for improvement between the two groups...

{snip}

Bottom line: I’m sounding like a defective parrot here because I say this so often, but we have to wait for controlled trials in order to say anything definite. Such trials are underway, with actual comparisons to standard of care, but they take longer. Fast trials are generally not very interpretable, interpretable trials are generally not fast. I will be glad to see these numbers when they appear, but don’t believe anyone who runs with a “Cure for Covid!” headline, because it’s extremely unlikely that remdesivir (a single agent with a broad mechanisms that’s not optimized for this virus) is any such thing. Remember, there are as yet no single-small-molecule antiviral cures for anything, coronavirus or not. My hope for the drug is that it is effective enough to get people out of the hospitals more quickly and to keep more of them off ventilators than if they were not taking it. For that hope to be realized, we need that comparison to the people who are not taking it. This trial doesn’t have it.


You can get more very worthwhile stuff like that from recent posts on vaccine and small molecule/targeted therapy developments as well as a summation of recent hydroxychloroquine trials.

Bottom line for me? When I need a reality- and science-based check on all of this stuff I will always look to Dr. Lowe, not Oz or Phil.

OK?


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Please note....As I've mentioned before, anti-viral drug development is most definitely not my field which is why I find Derek Lowe's perspective, rigour and expertise most helpful here.


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