As Amgen ramps up a clinical trial of its psoriasis drug Otezla in COVID-19, the company’s scientists may be seriously considering whether another of its blockbuster anti-inflammatories, Enbrel, could play a role in tamping down the virus.
CEO Robert Bradway hinted at that possibility during Fortune magazine’s Brainstorm Health virtual conference Tuesday.
“We have a couple of different ways I think to try to help ameliorate what looks to be a maladaptive immune response as [COVID-19] gets far advanced,” Bradway said.
Otezla, a PDE4 blocker, is being studied for its potential to prevent respiratory distress in patients with the virus. But the class of medicines that Enbrel belongs to, TNF inhibitors, is one “that we’re considering, as well, in this regard,” Bradway said.
A spokesperson for Amgen declined to provide more details to FiercePharma about its plans to examine TNF inhibition in COVID-19. In addition to Enbrel, which hauled in $5 billion in sales last year, the company’s anti-TNF portfolio includes biosimilar versions of Johnson & Johnson’s Remicade and AbbVie’s Humira.
There are several anti-inflammatory drugs in clinical trials for COVID-19, all with different mechanisms of action. Roche’s rheumatoid arthritis drug Actemra, for example, blocks interleukin-6 (IL-6), a cytokine that promotes inflammation, while Novartis’ Ilaris targets the cytokine IL-1beta. Studies have shown that these and other inflammatory cytokines can cause a dangerous immune reaction in COVID-19 patients.
Some of these trials have faced hurdles, as Bradway pointed out during the Fortune event. Earlier this week, Sanofi and Regeneron halted a U.S. trial of their IL-6 inhibitor Kevzara in coronavirus patients on ventilators after the drug failed to prevent deaths in a phase 3 trial.
And while the response to COVID-19 from the biopharma industry has been admirable, Bradway said, “it’s probably not as well coordinated as it could be.”
That said, Amgen continues to look for ways to contribute to the pandemic response effort. The company is working with Adaptive Biotechnologies to identify neutralizing antibodies against SARS-CoV-2, the virus that causes COVID-19. That work “is progressing very quickly. It's been quite a good collaboration,” David Reese, M.D., executive VP for research and development at Amgen, said during a Goldman Sachs conference call in June.
As for Enbrel and other TNF inhibitors, there have been a few published reports that could be fueling the interest in studying them in COVID-19. A study published in May in the journal Gastroenterology reported that in patients with inflammatory bowel disease, the use of corticosteroids was associated with severe COVID-19 outcomes—but the use of TNF inhibitors was not. And the Annals of Rheumatic Diseases recently published a case study of a COVID patient with spondyloarthritis who was taking Enbrel and ended up with a relatively mild case of the virus that resolved in 10 days, with no need for respiratory support.
While Bradway didn’t provide details about Amgen’s hopes for TNF inhibition in COVID-19, he said during that Fortune event that he’s “optimistic that through time we’ll be able to help bring down the risk of death from this infection.”