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Message: PNAS

"Hi Bear  Hapy New Year.Do I read you correctly with the impression that you are Luke warm as regards RVX and Covid?"

Happy New Year to you to! Yes, I would say I'm lukewarm. I posted about this not too long ago in this post, copied below, with respect to vaccine availability:

"My personal opinion, based on seeing the publicly available efficacy data and the safety profiles for the Moderna and BioNTech/Pfizer mRNA based vaccines, is that the world is going to have sufficient safe and effective vaccine available (from Moderna, BioNTech/Pfizer, and other non-mRNA based vaccines on the way) to make COVID-19 BET inhibitor therapies more or less pointless. By the time an apabetalone COVID-19 trial is complete, a large percentage of the world will likely have been vaccinated.

There may be space for apabetalone treatment of people who are infected but did not get vaccinated, or those who get infected despite getting vaccinated (due to vaccine waning or lack of protection). But if all goes as planned the widespread vaccination and hopefully herd immunity will make a second-line therapy like apabetalone unnecessary."

That post generated some back and forth, summarized here in this post.

Since these posts, the U.K. has approved the Astrazeneca/Oxford vaccine. This one will likely get US Emergency Use Authorization (EUA) by FDA in late Q1/early Q2. Additionally, Johnson & Johnson has two late stage ongoing trials for their promising vaccine, with interim results expected later this month and possible FDA EDU in Q1. That will make at least four total vaccines available likely before any apabetalone COVID-19 trial is even started. The Astrazeneca and J&J vaccines are very significant because these are adenoviral based, and not mRNA based, meaning they are cheaper and more stable the the temperature sensitive mRNA based vaccines. 

If an apabetalone COVID-19 trial is tested with an endpoint to prevent infection, I do not predict its efficacy to rival that of the vaccines. Therefore, I do not see much space for apabetalone as a drug that will gain traction to prevent infection. Instead, I think apabetalone has more potential to be used in people recently testing positive, or hospitalized, for COVID-19 in order to prevent severe COVID-19 and its consequences. 

Really depends on whether one wants a valuation/market perspective, or a real world clinical medicine perspective. I'm focusing on the latter; however, if they can show beneficial effects to slow rate of infection and/or decrease disease severity, this would obviously be expected to have a positive impact on valuation by the market.

BDAZ

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