Huijie Bian, Zhao-Hui Zheng, Ding Wei, Aidong Wen, Zheng Zhang, Jian-Qi Lian, Wen-Zhen Kang, Chun-Qiu Hao, Jing Wang, Rong-Hua Xie, Ke Dong, Jie-Lai Xia, Jin-Lin Miao, Wen Kang, Guoquan Li, Di Zhang, Mingru Zhang, Xiu-Xuan Sun, Likun Ding, Kui Zhang, Junfeng Jia, Jin Ding, Zhiqin Li, Yanyan Jia, Lin-Na Liu, Zhe Zhang, Zhao-Wei Gao, Hong Du, Na Yao, Qing Wang, Ke Wang, Jie-Jie Geng, Bin Wang, Ting Guo, Ruo Chen, Yu-Meng Zhu, Li-Juan Wang, Qian He, Rui-Rui Yao, Ying Shi, Xiang-Min Yang, Jian-Sheng Zhou, Yi-Nan Ma, Ya-Tao Wang, Xue Liang, Fei Huo, Zhe Wang, Yang Zhang, Xu Yang, Ye Zhang, Lu-Hua Gao, Ling Wang, Xiao-Chun Chen, Hao Tang, Shuang-Shuang Liu, Qing-Yi Wang, Zhi-Nan Chen, and Ping Zhu
Abstracts Recent evidence suggests that CD147 serves as a novel receptor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Blocking CD147 via anti-CD147 antibody could suppress the in vitro SARS-CoV-2 replication. Meplazumab is a humanized anti-CD147 IgG2 monoclonal antibody, which may effectively prevent SARS-CoV-2 infection in coronavirus disease 2019 (COVID-19) patients. Here, we conducted a randomized, double-blinded, placebo-controlled phase 1 trial to evaluate the safety, tolerability, and pharmacokinetics of meplazumab in healthy subjects, and an open-labeled, concurrent controlled add-on exploratory phase 2 study to determine the efficacy in COVID-19 patients. In phase 1 study, 59 subjects were enrolled and assigned to eight cohorts, and no serious treatment-emergent adverse event (TEAE) or TEAE grade ≥3 was observed. The serum and peripheral blood C max and area under the curve showed non-linear pharmacokinetic characteristics. No obvious relation between the incidence or titer of positive anti-drug antibody and dosage was observed in each cohort. The biodistribution study indicated that meplazumab reached lung tissue and maintained >14 days stable with the lung tissue/cardiac blood–pool ratio ranging from 0.41 to 0.32. In the exploratory phase 2 study, 17 COVID-19 patients were enrolled, and 11 hospitalized patients were involved as concurrent control. The meplazumab treatment significantly improved the discharged (P = 0.005) and case severity (P = 0.021), and reduced the time to virus negative (P = 0.045) in comparison to the control group. These results show a sound safety and tolerance of meplazumab in healthy volunteers and suggest that meplazumab could accelerate the recovery of patients from COVID-19 pneumonia with a favorable safety profile.