About every tenth corona infection leads to long-Covid, a really effective therapy does not seem in sight. There have already been healing attempts with groundbreaking success more than a year ago. How can that be? We spoke to the Erlangen doctor Bettina Hohberger, who administered the drug BC 007.
FOCUS Online: You are researching a drug that is a great hope for many long-Covid patients: BC 007. Can you explain why you are doing this as an ophthalmologist?
Bettina Hohberger: I know a lot of people are surprised about that. It’s very simple: the eye plays an important role in various systemic diseases. It’s not called the window for the body for nothing. We can see changes in high blood pressure or metabolic diseases, also in certain autoimmune diseases. I have been studying certain changes in glaucoma for years.
When the first wave of the pandemic started in 2020, patients with severe Covid-19 courses were also in the intensive care unit here at the Erlangen University Hospital for treatment. Together with Marion Ganslmayer, the senior physician in intensive care there, the idea came up of making changes that occur as a result of the virus infecting the innermost layers of the blood vessels visible. For me as an ophthalmologist, what was particularly interesting was that if we see a lack of blood flow in the eye, this is probably the case throughout the body.
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Hohberger: We gave the drug to four long-Covid patients and the success was actually impressive. The fact that such a long-lasting effect can develop after a single dose is unusual in autoimmune diseases.
So the patients were cured of Long Covid?
Hohberger: Be careful, it’s not like that, and unfortunately the whole thing is often misunderstood at this point. The idea that you only have to take this drug once and then be cured for life is wrong.
Perhaps we should think of the effect of BC 007 more like that of an allergy pill. If you have hay fever and take an antihistamine, you are temporarily free of symptoms. Next year, when the pollen starts flying again, there is a high probability that the problems will return.
Does that mean the long-term effects of the drug wear off over time?
Hohberger: BC 007 has a half-life of twelve minutes. After two days, there is nothing left of the active ingredient in the body. Accordingly, the patients should actually notice a deterioration after two days. But that was not the case. One of the four patients we treated relapsed after a few months. However, this cannot have anything to do with a diminishing effect of the drug.
Even if the drug had to be taken several times, it would probably be a blessing for many long-Covid patients. There is an intensive exchange on this in forums for those affected. The astonishment as to why BC 007 is not yet on the market is great. What do you say?
Hohberger: Healing attempts are a clinical activity – you help the patient in the current situation. If there is no treatment option for an illness with approved drugs, then experimental therapies can be carried out as part of healing attempts. If this success is achieved, the next step is to investigate this in a placebo-controlled study.
What is effect, what is placebo? This is an important question. And of course the consideration of whether such a drug can help everyone. This brings us to the next challenge: what actually is Long Covid? So far a diagnosis of exclusion. All of these factors make clinical studies, which of course go far beyond what happens in the treatment attempt and ultimately also the way to approval, demanding.
In fact, you haven’t stopped at healing attempts in the meantime, you’ve also done research on BC 007.
Hohberger: Yes, in December we started our clinical study “disCOVer” with public funds from the Bavarian state. This study aims to identify biomarkers in Long Covid. Biomarkers are clear changes that occur in the patient’s body and that can be visualized using innovative methods. This could make it possible to show different subgroups of Long Covid.
Which?
Hohberger: For some, the symptoms come from autoimmune processes. Others have suffered organ damage from the acute corona disease. In a third group, the body never managed to get the virus out of the body completely.
Can all three groups benefit from BC 007?
Hohberger: We do not assume that all long-Covid patients will benefit from BC 007. That’s why it’s so important to identify exactly the patients that BC 007 might be able to help.
BC007 was actually intended as a heart drug, they say…
Hohberger: Yes, years ago the manufacturing company BerlinCures sent it to an approval study for a serious heart disease – this is running in Serbia. In our house we have what I call “arms” walking. Originally we were in glaucoma. Then we expanded our work to Long Covid. And then there was increasing focus on MEC/FS, also known to some as chronic fatigue syndrome.
Another specialty of yours?
Hohberger: First of all, not at all, I didn’t know the clinical picture. The fact that the disease is so little communicated and there is no diagnosis and no causal therapy is a disaster – for patients and doctors alike. Those affected suffer and as a doctor you have neither a possibility to show this suffering objectively in the body nor a therapy that can help.
The spectrum of the disease is large: those affected can no longer go about their work, normal activities such as shopping are sometimes no longer possible. Some are bedridden.
You often hear something like this about Long Covid.
Hohberger: Right, we definitely see parallels there. Patients in whom Long Covid appears to be nothing more than a virally triggered autoimmune disease. More research needs to be done to understand this better. The path of the virus in the body needs to be better understood.
Many are surprised that it all takes so long. We all know how quickly the corona vaccination was launched back then. What about BC 007?
Hohberger: As a university, we can contribute all of our knowledge to work out the best possible criteria for studies. We are happy to make these available to a pharmaceutical company in order to make the approval of a drug as successful as possible.
But the approval study has to come from the pharmaceutical company. As a university hospital, we are a state-owned company for the well-being of patients, patient care, research and training.
Sounds like a clear separation.
Hohberger: Ultimately, it’s always best to work together, because then everyone’s knowledge can be used in a target-oriented manner. But yes, if you like: As a doctor, I know my area – approvals of vaccines by pharmaceutical companies do not belong in my field of activity. For me it would be the normal way for the manufacturer – in this case, as I said, a Berlin pharmaceutical company with a holding in Switzerland – to take care of investors.
And not politics?
Hohberger: Without exception, I have found the many discussions with politicians that we have had the opportunity to have – and these have been cross-party – to be courteous and helpful. As I say, where there’s a will, there’s a way!
If everyone pulls together – the university as an objective institution for patient care, politics and also the pharmaceutical companies, then that is certainly the best prerequisite for being able to offer patients a therapy option in a timely manner.
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