Revive Therapeutics Ltd (RVVTF)

[Giovanni]

Thank you

Good post:

As we all wait for the Data Safety and Monitoring Board to release a statement, I thought it would be a good idea to explain the findings of my research into the technical aspects of how Bucillamine might, or might not, work as a therapy for COVID-19.

I estimate the share price would be worth around 20 cents if the clinical trial results are unfavorable, and around $2-$5 if the results are favorable. A lot is riding, near term, on a favorable outcome.

Anyone who has been following this trial will know that the main concern is not safety, since the dosages of Bucillamine being used have been safe for over 30 years in treating rheumatoid arthritis in Asia. The question is, how effective will Bucillamine be in treating COVID-19?

Bucillamine often gets compared to Acetylcysteine (NAC), since it is a more powerful Thiol donor than NAC. It was believed that the anti-inflammatory effect, and general availability, of NAC would make it a good candidate to treat severe cases of COVID-19. That didn’t pan out: https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa1443/5910353

By designing the current trial to focus on mild and moderate cases of COVID, Revive does increase their chance of success, as well as the addressable population. It was also recently discovered that Thiol based drugs could disable the spike protein of COVID: https://revivethera.com/wp-content/uploads/2020/12/2020.12.08.415505v1.full_.pdf

That alone is promising, especially since Bucillamine is such a potent Thiol donor. But it is not fully indicative of what will happen. The same way I thought it was really irresponsible for people to start shilling hydroxychloroquine or ivermectin before they could be tested in-vivo. You never know that in-vitro results translate until you see how a drug interacts with everything else in the body.

On that front, we do know that Bucillamine tends to generate glutathione in-vivo: https://pubmed.ncbi.nlm.nih.gov/16806086/

That is also promising since COVID may be causing the biggest issues due to a decrease in endogenous glutathione: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7263077/

Which suggests that Bucillamine could be well positioned to prevent mild or moderate cases from becoming severe. So as a biomedical engineer who does clinical research, I’d say the preliminary data indicates a better than average chance of success. Bucillamine has more going for it than the average repurposed drug, but that doesn’t guarantee its success. Good luck everyone, hang tight for those interim Phase 3 results.

EDIT: The psilocybin program progressed, changing the lowest price I think Revive could go. Also the UK approved two similar rheumatoid arthritis drugs, which increases our likelihood of success, I’ll try to be conservative and estimate about 66% chance of success. https://www.the-scientist.com/news-opinion/uk-approves-arthritis-drugs-for-critically-ill-covid-19-patients-68333

I say the other two drugs are similar, even though the structures are quite different, because tocilizumab, sarilumab, and bucillamine all suppress interleukins (IL) to achieve their anti-inflammatory effect. Tocilizumab and sarilumab, were specifically designed to block IL-6. Bucillamine likely has a broader range of activity, since it calms B cells which “talk” to other cells using interleukins. https://pubmed.ncbi.nlm.nih.gov/8440072/
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