Today I'm going to be talking to Armand Balboni, MD, PhD, chief
executive officer of Appili Therapeutics, about favipiravir, a potential
COVID-19 treatment for elderly and long-term care populations.To get
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A recent analysis showed a surge in prescription pills for
hydroxychloroquine and chloroquine, likely due to off-label prescribing.
The JAMA study analyzed prescription patterns and found that
hydroxychloroquine/chloroquine fills increased by 1977% since last year.
States are slowly easing their barriers to pharmacists-provided COVID-19
testing. In early April, the US Department of Health and Human Services
(HHS) authorized licensed pharmacists to order and administer COVID-19
tests approved by the FDA. By mid-May, about two-thirds of states had
adjusted regulations for pharmacists-provided testing, but just a
handful of pharmacies have managed to navigate the maze of federal,
state, and supply-chain practicalities.
The company was founded in 2015 as a singly focused company, and the
idea was to tackle infectious diseases in a way that others don't or
can't. What we do is we look for unmet need first. So, is there a
disease out there in the infectious disease world where folks are not
able to readily find a solution, and we really try and match programs
then with the disease, and we do that in a way that's agnostic to where
something was created. And I think that's what's a little bit different
here. We're all scientists, either by training, or experience, or both.
We don't necessarily make the things in-house. Instead, we go and find
solutions to problems, which means that we have antifungals, 2
antibiotics, and now an antiviral program. For me, the daily mission is
one of trying to keep the team moving forward with the portfolio of
products which really touches on a number of really important diseases. I
like to say that we're a socially conscious biotech. We both do good
and we do well, and I know people roll their eyes when they hear that
you need to be a socially conscious biotech company. But we really are.
We really try and find those tough problems and then we really relish
the challenge to go find solutions.
So that's specifically looking at the antiviral program that we have
been working with Fujifilm Toyama Chemical. It's a drug called
favipiravir. It's a broad-spectrum antiviral. The long-term-care
setting, as many of us have seen and know, even though the pandemic has
not been going on for really that long, has disproportionately affected
those in the long-term-care setting-the elderly. It doesn't mean that
others can't get it, but we see a particular real serious problem there,
and in fact, in many places, including Ontario, where our first
clinical trial is being run for favipiravir in the long-term-care
setting, 80% of the morbidity and mortality has been associated with the
elderly, and so that that is really an unmet need, and it really fits
into our wheelhouse.
I think the other reason we're focusing on that group is just the
properties of the of the drug. Favipiravir is particularly well-suited
for that population based on its properties, which are: it's oral, it's a
tablet, unlike remdesivir, which is injected in an IV. And also, in the
elderly, even when a vaccine becomes available, and we all certainly
hope one will and I'm confident there will be one, the elderly don't
necessarily respond to vaccines in the same way that everyone else does.
Their immune system tends to be a bit more challenged. We think that
there will be a place for this drug. And then finally, we focused on
this group because nobody else was. We have the only randomized control
trial, looking at this population for prophylaxis, meaning we're giving
it soon-after infection as soon as possible, very early on in course of
the disease. And, you know, it’s the only trial in the world to look at
this really important population. So for all those reasons, we thought
that it was a good fit for us.
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