September 3, 2021

As we face a massive surge in COVID-19 infections caused by the Delta variant, it is crucial to have better treatments for those whose lives are challenged by COVID-19 infection.  It is wonderful to learn that the amazing CRISPR gene editing technology can be applied to treatment of COVID-19 infections (https://allianceforscience.cornell.edu/blog/2021/07/new-research-suggests-crispr-can-destroy-virus-that-causes-covid-19/). (The CRISPR methodology was the focus of the Keynote presentation at the 2018 IMWG Summi (https://www.myeloma.org/videos/how-crispr-could-impact-future-myeloma-treatment)t (https://www.myeloma.org/blog/dr-durie/why-imwg-summit-so-important).)

New CRISPR research 

An exciting study (https://www.nature.com/articles/s41467-021-24577-9.pdf) from the Cancer Immunobiology Program at Australia’s Peter MacCallum Cancer Centre was just published in the journal Nature. Using CRISPR gene editing technology with the bacterial enzyme Cas13, it is shown to be possible to “silence” or destroy more than 98% of COVID-19 virus production by eliminating the virus RNA. 

Translating this promising approach into a treatment for patients will take one to two years (maybe more), but it is incredibly encouraging that this might provide an approach that can treat all the emerging variants of the COVID-19. 

Additional new research (https://endpts.com/feng-zhangs-lab-develops-potential-breakthrough-in-rna-editing-delivery-with-ultracompact-versions-of-cas13/) from the laboratory of the Broad Institute’s Feng Zhang provides another potential breakthrough. Using “ultra-compact” versions of the Cas13 (a key component of the gene editing tools), the process works much more efficiently. Again, it will take time to assess the full impact of the pair of “ultra-compact” RNA editing tools developed by Zhang, but this can really be a major breakthrough in the application of CRISPR technology.

Bottom line

CRISPR gene editing technology applied to COVID-19 infections can be a breakthrough in treatment for COVID-19 and its many potential variants. Of note, yet another variant from Columbia is now being reported by the World Health Organization. The Mu variant (https://www.theguardian.com/world/2021/sep/01/who-monitoring-new-coronavirus-variant-named-mu) is clearly highly infectious. Whether or not it will be more problematic than the Delta variant remains to be seen. 

COVID-19 treatment landscape 

The CRISPR approach can add to the options for treating COVID-19 infections, which is great. But where are we with other options? A drug called ivermectin (https://www.nytimes.com/2021/08/30/health/covid-ivermectin-prescriptions.html) has recently been in the news. This is a medication used to treat parasite infections in cows (NOT viruses and not people!). There have been 10 trials evaluating ivermectin for COVID-19 infections, with negative or inconclusive results. Use of Ivermectin in patients with COVID-19 infections has been strongly condemned by the FDA (https://www.fda.gov/animal-veterinary/product-safety-information/faq-covid-19-and-ivermectin-intended-animals).  Higher doses of ivermectin have significant toxicities. 

Please do not consider use of ivermectin. 

COVID-19 recommendations 

The recommendations remain the same for myeloma patients:

• VACCINATION: Get vaccinated and also get a booster (a third dose of the Pfizer or Moderna vaccines) as soon as feasible. After the J&J vaccine, a follow-up booster is also recommended. Recent data from Israel (https://www.medrxiv.org/content/10.1101/2021.08.29.21262798v1.full.pdf) indicates that the booster can be important because COVID-19 antibody levels drop six to nine months after vaccination. 
• MASKS: Wear a mask in all situations of risk. A new, very large study from Bangladesh (https://www.washingtonpost.com/world/2021/09/01/masks-study-covid-bangladesh/) again emphasizes the positive impact of wearing a mask. 
• LIMIT POTENTIAL VIRUS EXPOSURE (especially if the community level of the Delta variant is high): Avoid crowds and indoor spaces with larger groups, especially if the vaccination status of group members is unknown or uncertain. 

The big picture

Caution is required until we get through the current Delta variant surge. Beyond that, we must be aware that additional “variants of concern (https://www.newsweek.com/how-many-covid-variants-mu-watchlist-1625472)” are likely, according to the World Health Organization and the CDC (Centers for Disease Control). So, stay vigilant. New boosters will become available. 

It is unfortunate that controversy at the FDA over the broader role of boosters has reportedly led two top officials in the vaccine program to step down (https://www.cnn.com/2021/08/31/health/fda-vaccine-officials-step-down/index.html). Hopefully, the vaccine data will be clear, and necessary future decisions will not be controversial. 

On the global front, the aggressive rollout of vaccination programs is essential to protect so many vulnerable groups and reduce the emergence of “variants of concern” that will have a global impact. 

Stay Safe. Stay strong. We will get through this together. 

Translations:

Arabic (https://www.myeloma.org/sites/default/files/Translations/Durie-Blog-090321-ARB.pdf)  Dutch (https://www.myeloma.org/sites/default/files/Translations/Durie-Blog-090321-DUTCH.pdf)  Italian (https://www.myeloma.org/sites/default/files/Translations/Durie-Blog-090321-ITA.pdf)  German (https://www.myeloma.org/sites/default/files/Translations/Durie-Blog-090321-GER.pdf)  Russian (https://www.myeloma.org/sites/default/files/Translations/Durie-Blog-090321-RUS.pdf)  Spanish (https://www.myeloma.org/sites/default/files/Translations/Durie-Blog-090321-ESP.pdf)