Dr. Fauci Talks COVID-19 with the ACR

Therapies & Vaccines
The National Institutes of Health (NIH) created a guidelines panel that regularly updates treatment recommendations at covid19treatmentguidelines.nih.gov based on newly published data and expert opinions, said Dr. Fauci. Two therapeutics have been recommended by the guidelines panel so far: remdesivir, an antiviral drug, for hospitalized individuals who have lung involvement, and dexamethasone, a corticosteroid, for hospitalized individuals who have ventilatory and/or high-flow oxygen requirements. A randomized, placebo-controlled trial showed that dexamethasone had a clear-cut benefit in reducing 28-day mortality in those patients, he said.⁸ Other investigative therapies include monoclonal antibodies and immunomodulators.

Potential vaccines are being developed with a strategic approach, with major investments by the U.S. government in the development and/or facilitation of testing of six of 11 current vaccine candidates, Dr. Fauci said.

“Harmonization of the protocols includes a common data and safety monitoring board, common primary and secondary endpoints, and common immunological laboratory parameters in order to bridge between each study,” he said. Multiple vaccine candidates are likely to be successful, because early data from animal studies and phase 1 trials showed robust levels of neutralized antibodies. “This makes us cautiously optimistic that we will have a successful vaccine by the end of this calendar year, and that we may be able to deploy a vaccine earliest in individuals at high risk, including medical personnel and people with underlying medical conditions, beginning in 2021,” he said.

Rheumatologists may view COVID-19 prevention trials or sign up to volunteer for any U.S. trial at www.preventcovid.org, he concluded.

(Author’s note: On Nov. 9, manufacturer Pfizer announced that BNT162b2, its two-dose mRNA vaccine candidate co-developed with German partner BioNTech, has demonstrated an efficacy rate of more than 90% against COVID-19 seven days after the second dose in previously uninfected individuals compared with placebo. The trial is not complete, but Pfizer distributed preliminary data in a press release, which noted that the final efficacy rate may vary and that no serious safety concerns have been noted among participants in the trial.⁹)

Susan Bernstein is a freelance journalist based in Atlanta.

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