How Medications like XOCOVA Prevent Illness After Exposure to COVID-19

While the general public may view the COVID-19 pandemic as a thing of the past, the virus continues to impact a significant number of people each year. Worse yet, many people who get sick with COVID find themselves facing long-term impacts, even after the initial sickness has passed.

Pharmaceutical Executive spoke with Florin Draica, senior vice president of US medical affairs at Shionogi, about the status of the disease and how new treatment methods are still being developed, such as XOCOVA. The FDA-approved medication is designed to be taken after exposure to the virus but before symptoms set in, in order to prevent serious illness.

Dr. Draica spoke about the ongoing impact of COVID, along with the industry’s broader need to start pursuing preventative medicines more often. By doing this, the public health playbook could focus on preventing illness while also treating people who still get sick.

Pharmaceutical Executive: How do medications like XOCOVA prevent illness after exposure to COVID-19?
Dr. Florin Draica: XOCOVA, which contains citalopram, is a protease inhibitor antiviral. After someone is exposed to COVID-19, the virus begins to replicate and multiply very rapidly — often before symptoms appear. That period between exposure and symptom onset, known as the incubation period, is critical. Acting quickly during this window can help reduce the risk of developing symptomatic COVID-19.

XOCOVA offers a new approach to prevention by blocking SARS-CoV-2 replication in that critical window between exposure and symptom onset. It does this regardless of a person’s prior infection history, vaccination status, or individual risk profile. XOCOVA should be taken as soon as possible and within three days of exposure to a person with COVID-19.

A few important points about our clinical evidence. In the SCORPIO-PEP trial, we did exclude participants who had been vaccinated within the prior six months. However, 70% of participants had received a COVID-19 vaccine at some point. We assessed antibody levels against the nucleocapsid and spike proteins of SARS-CoV-2, and found that virtually all participants — 98% — had detectable antibodies, indicating evidence of prior infection, prior vaccination, or both.

This is an important finding: XOCOVA works even in people who have prior immunity from vaccination or previous infection.

In terms of outcomes, even with the majority of participants demonstrating baseline immunity, XOCOVA demonstrated a 67% reduction in the proportion of household contacts who developed symptomatic COVID-19 compared to placebo through day 10.