Laboratory-grown antibodies may help the immune system fight coronavirus, but they are not a substitute for COVID-19 vaccination.
As COVID-19 cases continue to increase across the United States, the demand for monoclonal antibody treatments is increasing, especially in areas of the country with low vaccination rates.
According to the
It is especially useful for people with weakened immune systems who may not generate a solid response to COVID-19 vaccines and for others at high risk for serious illness.
Although monoclonal antibodies may begin to clear the coronavirus within hours of being injected intravenously (IV) into the body, this treatment may not work for everyone.
That is why experts recommend that people be fully vaccinated against COVID-19, which is known to prevent serious illness and hospitalization due to the disease.
A monoclonal antibody is a laboratory-produced protein that functions like antibodies produced by the immune system in response to infection.
By binding to a specific molecule on a virus or bacteria (known as an antigen), a monoclonal antibody can enhance or restore the immune response against these pathogens.
Treatment with monoclonal antibodies has been
Scientists are also developing monoclonal antibodies targeted at cancer cells.
Scientists sometimes develop monoclonal antibodies by isolating certain immune cells (called B cells) from a person who has successfully recovered from an infection.
With COVID-19, “we looked for people who had a good antibody response to the virus and chose the best antibodies they manufactured,” said Robert Carnahan, PhD, associate director of the Vanderbilt Vaccine Center in Tennessee.
Scientists use isolated B cells to recreate monoclonal antibodies in a laboratory. This can occur en masse and be given to people using an IV.
A monoclonal antibody targets a specific antigen of a virus or bacteria. Therefore, this treatment differs from convalescent plasma, which contains multiple antibodies directed to different antigens.
Most monoclonal antibodies that are developed to treat COVID-19 target the ear protein, which the coronavirus (SARS-CoV-2) uses to enter host cells.
By binding to the ear protein, a monoclonal antibody can help prevent the virus from infecting human cells.
Research suggests that certain monoclonal antibodies may reduce the risk of hospitalization and death in people with asymptomatic or mild COVID-19.
Scientists are also studying whether this treatment can reduce the risk of someone with COVID-19 transmitting the virus to other people in their household.
They have received several monoclonal antibodies
- REGEN-COV. This drug cocktail contains two monoclonal antibodies,
casirivimab and imdevimab . It is approved for people over 12 years old. - Sotrovimab. This medicine is authorized for adults and children over 12 years of age.
- Bamlanivimab / etesevimab. In June, the U.S. government stopped distributing these two monoclonal antibodies because tests showed they did not work against the beta and gamma variants of the coronavirus. The FDA recommends that healthcare professionals use other monoclonal antibodies.
The FDA has also given emergency approval to Actemra (tocilizumab) for the treatment of COVID-19 in hospitalized adults and children 2 years of age and older. This monoclonal antibody reduces the inflammation that occurs during COVID-19.
All of these monoclonal antibodies received emergency approval for the treatment of mild to moderate COVID-19 in people 12 years of age or older who tested positive for coronavirus and are at high risk for severe COVID-19.
This includes people who have a weakened immune system, older adults, pregnant women and people with obesity, diabetes or other chronic diseases.
While monoclonal antibodies can reduce the risk of serious disease in these people, complete vaccination is also important.
“If you are immunocompromised, I hope you are already vaccinated,” said Dr. Vincent Rajkumar, an oncologist at the Mayo Clinic. he wrote on Twitter.
“But in case you are not, the [recommendations] because monoclonal antibodies still apply to you: if you are exposed to someone with COVID or you have COVID, try to receive treatment with monoclonal antibodies, ”Rajkumar continued.
Both vaccinated people and those who do not meet these criteria are eligible to receive this treatment.
Treatment with monoclonal antibodies is usually done within 10 days after a positive COVID-19 test.
“If the [monoclonal] antibodies are administered relatively early in high-risk patients [the treatment] it can have an impact, “Carnahan said. However,” the later someone is in their disease, the less likely the antibodies are to be useful. “
The Regeneron antibody cocktail also has emergency approval for use in people at high risk for severe COVID-19 who were exposed to the coronavirus but have not yet shown positive or developed symptoms.
This is useful in situations where an unvaccinated person is exposed to COVID-19.
With mRNA dose vaccines, complete protection does not occur until 2 weeks after receiving the second dose. By then, people could already be seriously ill.
Shortly after exposure to the virus, “the vaccine will probably be of no use to anyone. It will not take effect soon enough for the person to be protected, ”Carnahan said. “While with antibodies, protection is available in a matter of minutes to hours.”
The CDC still
According to Kaiser Health News, the cost of the Regeneron two-drug cocktail is $ 1,250 per infusion. Currently, the federal government covers it.
Compare that to the cost of a single dose of the COVID-19 vaccine (about $ 20), which is also covered right now by the federal government.
The cost of the GSK and Vir monoclonal antibody costs approximately $ 2,100 per infusion. This is covered by a combination of government payments, refunds and GSK’s co-payment program, according to USA Today.
However, some infusion centers may charge treatment fees. They are covered by Medicare, Medicaid, and most private health insurance, although some plans may charge a copayment.
If you are unsure or worried about the cost, ask your treatment center in advance if you will be charged for the infusion.
To receive treatment with monoclonal antibodies, you must have tested positive for COVID-19 within the last 10 days. You will also need a referral from a healthcare professional.
If you seek treatment after exposure to the virus and before a test or positive symptoms, talk to your doctor about your options.
Treatment with monoclonal antibodies is offered in outpatient centers, hospitals, emergency care centers and some medical offices across the country. The U.S. Department of Health and Human Services has a search engine for infusion locations on its website.
Although many infusion centers are expanding across the country, experts point out that monoclonal antibody treatment is not a substitute for COVID-19 vaccination.
“Because of their ease of delivery and low cost, vaccines will be superior [monoclonal] antibodies in many situations, “Carnahan said.” That’s why everyone should be vaccinated. Vaccines will provide – hopefully – long-term lasting immunity in an easy-to-distribute format. “