Monoclonal antibodies for COVID-19: how they work and who is eligible

Preventing COVID-19 from making people extremely sick or landing them in hospital is the public health goal of the pandemic, and the main job of the coronavirus vaccines. While monoclonal antibody therapy has been around for decades, COVID-19 monoclonal antibodies (lab-made antibodies given to a person that help their immune system prevent the spread of infection) have gained credibility as a tool. key to protecting those most at risk of severe COVID-19. Preliminary research shows that treatment reduces the risk of hospitalization or death by about 70%.

Former President Donald Trump received Regeneron monoclonal antibody treatment during his presidency, as did Greg Abbott, Governor of Texas, when he tested positive for COVID-19 this month. These treatments are urgently authorized by the Food and Drug Administration for people 65 years of age and older and certain people 12 years of age and older, including people with obesity, diabetes and heart disease. It is important to note that antibody therapy must begin before COVID-19 turns into serious illness or hospitalization, usually within the first 10 days of symptoms (or sometimes, as in Governor Abbott’s case, before the onset of symptoms. On Saturday he tweeted that he is now testing negative for COVID-19).

Monoclonal antibodies are not a substitute for preventative COVID-19 vaccines, but some public health officials have criticized the lack of awareness and access to monoclonal antibody therapy. Dr Rajesh Gandhi, an infectious disease physician at Massachusetts General Hospital, told the New York Times more needs to be educated about the effectiveness of monoclonal antibodies in preventing serious illness.

“Patients should know how to call their doctors,” Gandhi said. “In 2020, people with mild COVID were told to stay home. This message needs to pivot towards a more proactive message.”

More and more healthcare providers are starting to take advantage of antibody treatments, and the drug itself is free, under an agreement reached by the federal government. Regeneron, the leading maker of monoclonal antibody drugs, delivered nine times more doses of its treatments to U.S. hospitals a week in August compared to the previous month, the Wall Street Journal reported. Additionally, Texas and Florida recently opened state-run monoclonal antibody treatment centers that are accessible to people at risk of severe COVID-19 and in the early stages of their illness.

So what exactly are monoclonal antibodies? And who needs it? Here is a summary of what we currently know about antibody treatments for COVID-19 in the United States.

What are monoclonal antibodies and how do they work?

Monoclonal antibodies are antibodies made in the laboratory that work by binding to bacteria, cancer cells or viruses like natural antibodies do, preventing them from infecting more cells. The first monoclonal antibody therapy was approved over 30 years ago, and the treatment has been used for conditions such as rheumatoid arthritis, cancer and HIV, according to the International AIDS Vaccine Initiative.

Monoclonal antibody treatments for COVID-19 are used before a person really gets sick, usually within 10 days of their first symptom, to avoid hospitalization. The treatment is only approved for people who are at risk of becoming extremely ill – those who are 65 years of age or older and those who have “certain medical conditions,” according to the FDA. Treatment is also approved if a person at risk is exposed to COVID-19.

Who is eligible? Can I ask my doctor for treatment if my test is positive?

If you do catch the coronavirus and are worried about how the disease will affect you, contacting your doctor to find out about your options and the best line of treatment for you is a good idea. But, in general, this specific treatment is reserved for people at risk of serious illness. Most people infected with COVID-19 will recover at home without medical help.

More people are eligible for monoclonal antibody treatment if they test positive for COVID-19 than those currently eligible for a extra dose of COVID-19 vaccine. Those who are at least 12 years old and may be eligible for monoclonal antibody treatment because of their individual risk, according to the FDA, include:

• All people aged 65 and over.
• Obese or overweight people (adults with a BMI over 25 and children aged 12 to 17 with a BMI of the 85th percentile or higher).
• Pregnant people.
• People with chronic kidney or lung disease (including asthma).
• People with cardiovascular disease or high blood pressure.
• People with diabetes.
• People with sickle cell disease.
• Those who live with neurodevelopmental disorders.
• People who are immunocompromised or taking immunocompromised medicines.
• Those who have a “technological dependency related to medicine” (such as a tracheostomy or gastrostomy).

Other conditions may also put you at a higher risk of complications from COVID-19 and make you a candidate for antibody treatment. If you think this applies to you, ask your doctor and see the Centers for Disease Control and Prevention page for “People with Certain Medical Conditions.”

I qualify. How to access the treatment?

Monoclonal antibodies are given intravenously or by injection (a series of four injections, so this is not a prescription that you can easily pick up at the pharmacy). According to CNN, the infusion process takes about an hour and patients have to wait a while for side effects. If you’re at risk for severe COVID-19 and have tested positive or think you have it, ask your doctor where treatment is available.

If you live in Texas or Florida where there are state-run monoclonal antibody treatment centers, the same patient eligibility requirements apply. In Florida, that means anyone aged 12 and over who is at “high risk of serious illness” can make an appointment and find a monoclonal treatment center at any of the state’s eight sites. In Texas, there are currently nine antibody infusion centers across the state, but those at risk need a referral from their doctor.

If you believe you are eligible for monoclonal antibody treatment but do not have a health care provider, you can call the Combat COVID Monoclonal Antibodies call center at 1-877-332-6585. You can also use this link from the US Department of Health and Human Services Antibody Therapy Researcher.

It’s free? If so, which brands?

In July 2020, the US government signed a deal with Regeneron, which made doses of the drug free to Americans once the company obtained authorization for emergency use (which it did in November). . In March, the government invested more money to expand access to monoclonal antibody therapy. However, you will still have to pay for the administration of the treatment, according to the United States Centers for Medicare and Medicaid Services. Medicare, Medicaid and private insurance will cover administrative costs, the Washington Post reported.

Regeneron is currently the only free brand of monoclonal antibodies to US citizens. An antibody treatment made by GlaxoSmithKline also has emergency use authorization, but it is not free, according to the CMS. There are also antibody treatments made by Eli Lilly that previously had emergency use clearance, but they have either been suspended in distribution or revoked, according to the CMS.

Do monoclonal antibodies interfere with coronavirus vaccines?

If you have been treated with monoclonal antibodies and have not yet been vaccinated, you must wait 90 days after your treatment to make an appointment, according to the CDC. This recommendation is valid until more is known about how the antibody response of treatment affects the immune response resulting from vaccination.

Bottom Line: Monoclonal antibodies to COVID-19 are a type of treatment for the disease and are not a substitute for coronavirus vaccines.

The information in this article is for educational and informational purposes only and does not constitute health or medical advice. Always consult a doctor or other qualified healthcare professional with any questions you may have about a health problem or health goals.