RSV infections can lead to serious conditions for patients with impaired lung capacity, such as COPD patients. Today there are no treatments for the virus, but that is soon about to change. BioStock takes a closer look at this respiratory illness and the drug candidates that are advancing towards market approval.
Respiratory drugs make up one of the largest pharmaceutical markets today. In 2021, annual sales of respiratory drugs accounted for just over 150 billion USD. The respiratory drugs market is expected to show continued steady growth, reaching expected sales of just under 300 billion USD by 2026. Despite this large market, not all respiratory conditions can be treated with today’s available drugs.
RSV especially severe for COPD patients
Infections in COPD patients can often lead to serious medical conditions. They can be caused both by bacteria and viruses, one common such virus is the respiratory syncytial virus, or RSV. Infections caused by RSV occur in the respiratory tract and can cause anything from mild colds to serious lung infections that require hospitalisation. The virus affects about 63 million people and leads to approximately 160,000 deaths each year. RSV is especially dangerous for people with chronic obstructive pulmonary disease (COPD), who already have impaired lung function and are thus more susceptible to infections.
These infections can worsen the symptoms of COPD and can lead to serious complications, such as pneumonia or respiratory failure. Episodes of acute worsening of COPD are difficult to control with today’s medications and are the main cause of death for COPD patients.
Between 20 and 50 per cent of all COPD patients who suffer from acute exacerbations have some form of viral infection, with RSV being one of the most common variants. For the seriously ill COPD patients, with poor lung capacity, an exacerbation can be life-threatening. There is currently no adequate treatment that prevents patients’ lung function from being reduced over time. Therefore, the profession sees a great need for new drugs that prevent the underlying disease of COPD patients from worsening.
Two vaccines recommended
As for RSV, there are currently no approved drugs available, either for COPD patients or other patients. Treatment consists mainly of symptom relief and supportive care. This means that healthcare professionals focus on managing the patient’s symptoms, such as coughing and shortness of breath, and ensuring that the patient receives enough oxygen.
This may soon change, as there are several drugs nearing market approval. Recently, the FDA’s advisory panel recommended that the agency approve two new vaccines against the virus. The two vaccines are being developed by Pfizer and GSK, respectively. By all accounts it looks like they could receive approval from the FDA, despite some question marks about the safety of the two vaccines. In most cases, the FDA usually follows the advisory panel’s recommendations. If this is the case, the vaccines will be available to patients 60 years of age or older.
More treatments on the way
In addition to these two vaccines, AstraZeneca and Sanofi are awaiting the FDA’s verdict regarding Beyfortus, a monoclonal antibody treatment for children up to the age of 2 affected by RSV.
Moderna also operates in this field. The biotech company, which became wellknown thanks to its mRNA-based Covid-19 vaccine, is developing an RSV vaccine for elderly patients. The company aims to apply for market approval to the FDA in the first half of 2023. Dutch Janssen and Danish Bavarian Nordic are two further examples of companies developing RSV vaccines.
Continued great need for COPD treatments
It looks like treatment will soon be available for RSV patients, adding another piece to the treatment puzzle. At the same time, there is still a great need for new treatments for serious respiratory conditions such as COPD, with better efficacy and a better side effect profile. Above all, people are looking for treatments that specifically attack the underlying disease factors. There is a particular focus on the inflammatory component related to the acute exacerbations.
Dual and alternative mechanism of action
One project in the sector is RCD405, which is run by Lund-based Arcede Pharma. The drug candidate differs from today’s treatments in that it has an alternative mechanism of action and targets other receptors and enzymes compared to available drugs. In addition, it has a double mechanism of action, which makes it act both as a bronchodilator and an anti-inflammatory drug.
The company is in the final preclinical stage. Right now it is awaiting the start of the final part of the toxicological program. Last autumn, Arcede Pharma presented preliminary results from the first part of the program. It showed that RCD405 is well tolerated and did not produce any unexpected effects or side effects.The content of BioStock’s news and analyses is independent but the work of BioStock is to a certain degree financed by life science companies. The above article concerns a company from which BioStock has received financing.