Increasingly, doctors have prescribed intravenous treatments with drugs known as monoclonal antibodies to prevent hospitalization for people with COVID-19.
Throughout Texas, the state has opened regional infusion centers to provide monoclonal antibody treatment for infected people 12 and older who have mild-to-moderate symptoms, meet certain criteria and have a doctor’s prescription.
In this video, Dr. Jan Patterson, an infectious disease expert at University Health and UT Health San Antonio, explains how these manmade antibodies attack the COVID-19 spike protein and prevent the virus from entering the cell.
While they are not an alternative to vaccination, Dr. Patterson says monoclonal antibodies have proven to be effective in preventing the progression of the disease in many patients with mild-to-moderate COVID-19 symptoms.
Monoclonal antibodies are now being used to treat patients with COVID-19. What are they?Monoclonal antibodies are a synthetic or laboratory-made version of antibodies against the coronavirus. They actually attack the spike protein and inhibit the entry of the virus into the cell.
Which patients qualify for monoclonal antibody treatment?
Monoclonal antibodies are given for patients who are diagnosed with COVID but have mild to moderate disease and are at high risk for progression. So anyone 12 or older that's at high risk for progression, and that would include people who are overweight or obese, people with diabetes, with chronic kidney disease, heart disease, lung disease, those who are immunosuppressed, and people who have other complex medical conditions, and people over 65. Those are all at high risk for progression, so they can all be candidates for monoclonal antibodies.
How does a patient gain access to monoclonal antibody infusions?
People should contact their doctor, and their doctor can evaluate them and be able to decide if they're a candidate for therapy. Then they can refer them to an infusion center because these need to be infused by an IV infusion. It is possible to give it subcutaneously now but that's more difficult and not usually done. It's usually done by an IV infusion. It has to be done at a special infusion center because these are people who have COVID and are contagious so it needs to be done at a designated infusion center.
How effective are monoclonal antibodies in keeping COVID-19 patients out of hospitals?
They are effective and they currently are under an emergency use authorization (EUA), so they're not FDA approved at this point. But we do know that they're effective and they decrease your risk of progressing to severe COVID by about 70%. It needs to be given as soon as feasible after you're diagnosed, but at least within 10 days of the diagnosis. It's not for people who are hospitalized with COVID or who are on oxygen therapy with COVID, because it can actually make those people worse. So it has to be given early in the course of disease.
How does the COVID-19 vaccine affect your eligibility for monoclonal antibody treatment?
You can still get this therapy if you are fully vaccinated. But you do need to be in that category of somebody who's got mild to moderate disease and at severe risk of progression. Another question comes up, like if you have this antibody, can you get vaccinated? And yes, you still can get vaccinated. We recommend waiting for a period of time because these antibodies are protective for about three months, or 90 days. We think it's best to wait to get your vaccine after that time so that this antibody doesn't compete with the vaccine response.
Are monoclonal antibodies a substitute for COVID-19 vaccination?
The main thing to realize is that still the best protection against progressing to severe disease is getting the vaccine and getting those two doses. That's still our best protection against severe disease, hospitalization and death.