Two recent clinical trials found that taking antibody treatments can reduce the severity and prevent deaths in people with mild to moderate COVID-19.
According to Nature, an antibody developed by Vir Biotechnology headquartered in San Francisco and GSK located in London, England reduced the risk of hospitalization and deaths in COVID-19 patients by 85%. In a separate trial, the antibody cocktail consisting of bamlanivimab and etesevimab created by the pharmaceutical giant Eli Lilly slashed that risk by 87%.
Dr. Derek Angus, a critical care specialist and professor at the University of Pittsburgh School of Medicine, said the recent trials, which have not yet been published, add to the growing body of evidence that antibody treatment can help stave off severe COVID-19 disease.
“I’m very excited about the results of these trials,” he said, according to Nature, adding that they “appear to be incredibly effective.”
The antibody VIR-7831 developed by Vir and GSK, was identified in 2003 in a person recovering from severe acute respiratory syndrome or SARS caused by a similar coronavirus to the one that causes COVID-19. Scientists later found that the antibody was able to bind to the spike protein of SARS-CoV-2 that triggers COVID-19.
The antibody can also bind to the more contagious South African variant sweeping the globe, according to Nature. VIR-7831 is now the most recent addition to the many monoclonal antibodies tested to treat COVID-19. Some, like the Eli Lilly combo, have been approved by the Food and Drug Administration.
However, their use has been limited, says Angus, because administering the treatment is costly and there have been mixed reviews on their efficacy.
Monoclonal antibodies are highly recommended for those over the age of 65 or who have underlying medical conditions that put them at risk from severe illness. Former President Donald Trump received the Regeneron antibody treatment shortly after he was diagnosed with COVID-19 last year.
Public health officials have asked healthcare practitioners across the country to take advantage of the plentiful supply of these monoclonal antibodies that are currently the only approved treatment that could keep Americans out of hospitals as well as could slash hospitalization time by half, according to studies.
“This is the first time during the pandemic that I can recall when our resources far exceed demand,” said Dr. William Fales, of the Michigan Department of Health & Human Services, according to NBC News.
Experts say that there are several reasons why monoclonal antibodies are not more widely used. Firstly, they must be administered soon after a person tests positive for COVID-19 during the first week of illness. While some states, notably Ohio, have put an electronic recording system into use that alerts healthcare practitioners if patients’ swabs come back positive, other states do not have such a rapid response system in place.
Secondly, the hour-long infusions of both the Regeneron and Eli Lilly monoclonal antibodies must be given intravenously, and appointments can last between 3 to 4 hours, according to NBC News. Since COVID-19 patients can infect others, they must be kept in a separate room. This can seriously hinder the administration of the drugs in a local clinic or even in a physician’s office.
Dr. Peter Chin-Hong, an infectious disease specialist at the University of California at San Francisco, cites public transportation as another roadblock to the antibody treatment. Any type of shared ride is out of the question for COVID-19 patients and some patients cannot afford to spend half a day for treatment away from family obligations and work, he said.
And then there is the cost. Since the therapy is given intravenously, a single dose costs $1,250, according to published reports. Even though the federal government has agreed to distribute the drugs free of charge, the infusion alone can cost $1,000, which may result in hefty copayments even for people who are insured.
According to Nature, it will be quite a while until everyone is vaccinated and using monoclonal antibodies to bridge that gap could save lives.
“It is not a replacement for vaccines, but it is a plan B,” said Professor Jens Lundgren, an infectious disease expert at the University of Copenhagen in Denmark.
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