Monoclonal antibody treatment is now seen as a relatively effective and safer alternative in treating COVID-19 patients, with doctors stating that, as with any other drug, timing is very important for the administration of the therapy that’s touted as a game changer.
“If given within 72 hours of the appearance of symptoms, it is proven to show good results and could be the way forward in tackling the SARS-CoV-2 virus,” doctors note. Monoclonal antibodies have previously been used to treat infections such as Ebola and HIV. The therapy is now said to help avoid hospitalisation in high-risk groups, progression to severe disease, and to reduce the usage of steroids.
“Monoclonal antibody treatment isn’t a one-size-fits-all therapy. It is to be given only to mild COVID-19 patients who are not requiring oxygen, and there is high risk of progression or hospitalisation due to existing comorbidities,” warns Akshay Budhraja, senior pulmonologist, Aakash Healthcare.
“Antibodies for COVID target specific proteins and destroy them before they initiate inflammation, which causes worsening of symptoms like breathlessness, blood clotting and severe pneumonia. In simple words, antibody response, which takes 7-10 days after infection, gives the virus the window period to attack the body. This window period is covered by injecting monoclonal antibodies, which help in reducing the symptoms and disease progression,” said Dr. Budhraja.
He added that the therapy was offered to a few high risk patients and none of them progressed to severe COVID-19 requiring hospitalisation.
“It seems to be a useful molecule, effective against mutant strains as well, and prevents progression of COVID if given at the right time. No major side effects were noted among patients in our hospital who were given this therapy, and none of those patients were hospitalised due to COVID progression,’’ he added.
Doctors explain that among the other known benefits of monoclonal antibodies is lesser requirement of steroids and other immune-suppressive drugs, the main cause of secondary infections, uncontrolled blood sugar levels and other post-COVID-19 complications.
In the national capital, the therapy was successfully used in two patients recently — a 36-year-old healthcare worker and an 80-year-old male at the Sir Ganga Ram Hospital. According to the doctors here, both patients showed improvement within 12 hours of administering the treatment.
Treating physician Pooja Khosla, senior consultant, Department of Medicine, Sir Ganga Ram Hospital, said that the two patients were administered REGCov2 (Casirivimab and Imdevimab), designed to produce resistance against the SARS-CoV-2 coronavirus.
“Monoclonal antibody treatment could prove to be a game changer in times to come if used at the appropriate time. It can be given up to 10 days from the beginning of the symptoms and is not for low oxygen level patients. This awareness about early identification of the high risk category in our population and timely therapy with monoclonal antibody as day care treatment may reduce the burden of cost on the healthcare sector,” Dr. Khosla said.
The doctor added that monoclonal antibody therapy cost ₹60,000-70,000 and significantly reduced hospital stay. “The key principle while using the therapy was that it should be given at the right time to the high risk group,” she said.
“Currently, there is no shortage of the drug and patients should be aware that the treatment can be offered only at a hospital and after evaluation by a physician. It is administered intravenously over an hour. So far, we are getting good results,” she added.
Speaking about his father, R.K. Razdan, the male senior citizen who has benefited from the treatment, Dr. Anup Razdan, senior consultant, Department of Dental Surgery, Sir Ganga Ram Hospital, said, “My father is currently doing well after the therapy and has been discharged from the hospital. It was an informed decision to take this therapy, which is known to show positive response when used in some cases across the country. The use of steroids is showing several side-effects. My father has some minor medical complaints, and after discussion with the doctors, we decided to opt for the therapy. My father showed improvement in 12 hours and has been able to sustain his improvement.”
Mr. Razdan is diabetic and hypertensive, and was admitted to the hospital with a high grade fever and cough. His oxygen saturation was more than 95% on room air. A CT scan confirmed mild COVID-19 disease. He was given REGCov2 on Day 5 of the disease. The patient’s parameters improved within the next 12 hours.
Also, doctors at BLK-Max Hospital, who used the therapy for two COVID-19-positive senior citizens with heart complications, noted that the patients turned negative for the disease a week after they were administered monoclonal antibody therapy. Sandeep Nayar, senior director, BLK-Max Centre for Chest and Respiratory Diseases, said the two men were administered the antibody cocktail therapy within three days of obtaining their COVID-19 reports.
Meanwhile, speaking about making monoclonal antibody treatment available across India, a senior Health Ministry official noted that the Central government had set-up a committee to look at new information on the COVID-19 virus from around the world.
“The COVID treatment guideline is a dynamic document. It has already undergone multiple additions and subtractions, depending on the emerging data. The government is working at ensuring that there is no shortage of drugs at any centres. We are also conducting workshops to update the medical community on the new data that we are obtaining. This is an ongoing process,” said the official.