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COVID-19 Treatment Developed In St. Louis To Begin Human Trials

June 22, 2020 Joe Monahan Walter Smith
Provided by Confluence Discovery Technologies

COVID-19 remains a mystery in many ways, but as it continues to rampage through the world’s population, some things are becoming more clear. One of them is that cytokine storms — a “deranged immune response” to the virus, in which the body literally attacks its own cells instead of the invading coronavirus — appear to be one reason some patients end up extremely ill.

A drug developed in St. Louis aims to combat those cytokine storms. Called ATI-450, it was originally developed by Confluence Discovery Technologies in 2013 with the idea of helping people suffering from autoimmune diseases, particularly rheumatoid arthritis.    

But as scientists began to understand the way COVID-19 affects the body, the company realized it could potentially help with the new coronavirus as well.

“We’re actually in a Phase 2 rheumatoid arthritis study,” explained Joe Monahan, Confluence Discovery Technologies’ executive vice president of research and development, on St. Louis on the Air. “That started earlier in the year. But when we saw what was happening with COVID back in January or February, and we started to think about the possibility of both COVID being driven by the cytokine storm in the lung, and [rheumatoid arthritis] being driven by a similar storm of cytokines regulated in the joint, we thought maybe we could do some quick studies in the laboratory to validate that ATI-450 may have an impact on these cytokines in the lung, and in particular things driven by the SARS CoV-2.”

Added Monahan, “It was the right place at the right time.”

And so even as most businesses around St. Louis closed their offices and moved to remote work this spring, Confluence doubled down. With staggered shifts and seven-day workweeks, researchers in its headquarters at Cortex’s BioSTL building were able to show strong enough results in the lab to receive FDA approval to begin human trials. 

Those are to begin in two weeks at the University of Kansas Medical Center, Monahan said. Thirty-six patients will be given the drug in a double-blind, placebo-controlled study.

The company hopes to show that, by blocking the pathways used to make cytokines, ATI-450 stops the cytokine storms that can be so damaging. Explained Monahan, “In so doing, we believe that we would reduce the [acute respiratory distress syndrome] observed in these patients, and reduce the need for mechanical ventilation, decrease the hospital stay, and reduce the mortality.”


Normally, good results in such a study would mean another three to six years before bringing a drug to market. But Monahan has hopes for a speedier process for ATI-450 when it comes to COVID-19.

“If this works really well [against] the disease, and we expand it to more people and it continues to work, I think there’s an ability to really shorten those timelines,” he said.

Confluence was acquired by Pennsylvania-based Aclaris Therapeutics in 2017, but its researchers remain based in St. Louis. Monahan helped to co-found the company as part of BioSTL after spending 28 years at Pfizer and its legacy companies. The pharmaceutical giant was moving a unit to the Boston area, and rather than relocate, Monahan and some colleagues decided to stay in St. Louis and go out on their own.

“We had maybe some different ideas on how to do drug discoveries that we had not been able to do at Pfizer,” he said. 

St. Louis on the Air” brings you the stories of St. Louis and the people who live, work and create in our region. The show is hosted by Sarah Fenske and produced by Alex Heuer, Emily Woodbury, Evie Hemphill, and Lara Hamdan. The audio engineer is Aaron Doerr.

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Sarah Fenske served as host of St. Louis on the Air from July 2019 until June 2022. Before that, she spent twenty years in newspapers, working as a reporter, columnist and editor in Cleveland, Houston, Phoenix, Los Angeles and St. Louis.
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