As I mentioned in the December 7th post, bamlanivimab, a monoclonal antibody (A type of protein made in the laboratory that can bind to substances in the body, including cancer cells. There are many kinds of monoclonal antibodies. A monoclonal antibody is made so that it binds to only one substance) to Covid-19 is available in San Antonio. As it turns out another antibody treatment is available as well. Casirivimab and imdevimab are two monoclonal antibodies used in combination made by Regeneron and are being used in San Antonio. People commonly refer to it as Regeneron, but that is the manufacturer. This is the one that President Trump, Chris Christie and Rudy Guiliani received. There are logistical hurdles to administering them which are being overcome, but the roll out nation wide has been slow. There is a Regional Infusion Center at Joe Freeman Coliseum and Methodist Healthcare System is doing them at Legacy Emergency Room. Today they are adding two other locations with a fourth to come soon in ’09. Other hospitals may be administering them as well.
Only small percentage of available monoclonal antibody supply being used, data indicate
Reuters (12/16, Beasley) reports, “U.S. hospitals have been slow to embrace COVID-19 antibody drugs from Eli Lilly and Co and Regeneron Pharmaceuticals Inc that have been authorized to reduce the risk of hospitalization, U.S. officials said on Wednesday.” According to Reuters, “health care systems say they have been slow to ramp up use of the antibodies due to extra levels of complexity during the pandemic – including requirements for quick diagnosis times and the need to isolate infectious patients.”
CNN (12/16, Kane) reports that “early study results show” monoclonal antibodies “may reduce the rate of hospitalizations by up to 70% if they are taken in time, which can be life-saving, especially among people who are at high risk of getting very sick.” CNN adds that “an HHS spokesperson confirmed that a new report showed only 5%-20% of the available supply of monoclonal antibodies are actually being used.”
Is one better than the other? We don’t know. They are both approved under EUA for mild to moderate disease in patients at high risk of progression to severe Covid -19. They have to be given in the first 10 days of the illness. Here are the criteria:
High risk for progressing to severe COVID-19 and/or hospitalization is defined as patients who meet at
least one of the following criteria:
• Have a body mass index (BMI) ≥35
• Have chronic kidney disease
• Have diabetes
• Have immunosuppressive disease
• Are currently receiving immunosuppressive treatment
• Are ≥65 years of age
• Are ≥55 years of age AND have
o cardiovascular disease, or
o hypertension, or
o chronic obstructive pulmonary disease/other chronic respiratory disease.
• Are 12 – 17 years of age AND have
o BMI ≥85th percentile for their age and gender based on CDC growth charts,
https://www.cdc.gov/growthcharts/clinical_charts.htm, or
o sickle cell disease, or
o congenital or acquired heart disease, or
o neurodevelopmental disorders, for example, cerebral palsy, or
o a medical-related technological dependence, for example, tracheostomy, gastrostomy, or
positive pressure ventilation (not related to COVID-19), or
o asthma, reactive airway or other chronic respiratory disease that requires daily medication
for control.
THIS IS AN EXCITING DEVELOPMENT!
