Antibody treatments for covid-19: everything you need to know

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(CNN) -

When Texas Governor Greg Abbott announced Tuesday that he had tested positive for covid-19, his office shared that he was treated with monoclonal antibody therapy.

This has not yet been approved by the US Food and Drug Administration (FDA), but it is one of the few that has been shown to be effective against the virus.

Monoclonal antibodies like those made by Regeneron and GlaxoSmithKline will not work for all COVID-19 patients.

MAbs, as they are known, are only available to people 12 and older who are not hospitalized or seriously ill.

• Texas Governor Greg Abbott tests positive for COVID-19

Regeneron therapy can also be used for some people who know they were exposed to the virus, but do not yet have a positive test.

However, that protection does not last long and does not replace the vaccine.

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A therapy that is applied in several states

With his treatment of Regeneron, Abbott joined a list of high-profile conservatives, including Chris Christie, Rudy Giuliani and President Donald Trump, who relied on the therapy.

Florida Governor Ron DeSantis, who, like Abbott, has banned health passports and mandatory face mask orders in schools, has been promoting the treatments at events.

Florida also created a rapid response unit to administer treatments to residents infected with the virus.

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"These monoclonal antibodies, Regeneron and others, have been shown to radically reduce the chance that someone will end up being hospitalized. And, at the end of the day, reducing hospital admissions should be a top priority. If you reduce those admissions, people are not going to the hospital. hospital to begin with. You know they are going to recover and that is something really important, "said Republican Governor DeSantis.

It does not replace the vaccine

Treatments are effective in reducing severe disease.

However, some scientists have criticized the push for these treatments over easier prevention methods.

"We know what works to prevent people from getting this disease. First of all, the use of masks and vaccination. We should focus on these preventive measures," said Dr. Leana Wen, emergency physician and visiting professor of politics and health management at the George Washington University Milken Institute School of Public Health.

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"It is totally backwards to say that we should focus on treatment rather than emphasizing prevention, and the steps that we know work to stop COVID-19 in the first place."

What you should know about monoclonal antibodies

What is a monoclonal antibody?

Monoclonal antibodies are laboratory-made proteins that can mimic the immune system's ability to fight threats like coronavirus.

When a patient is infected, it takes a while for his body to produce antibodies that can help him fight the infection.

These treatments, also known as mAbs, can speed up the body's ability to fight infection.

Two mAbs made specifically to fight the coronavirus are in use in the United States right now.

The FDA granted an emergency use authorization for a treatment by Regeneron called casirivimab and imdevimab, and another by GlaxoSmithKline, called sotrovimab.

So far, none have received full FDA approval.

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In April, the FDA revoked its emergency use authorization and put Eli Lilly's antibody treatment bamlanivimab on hold because it was not as effective against the variants circulating in the US.

In June, HHS announced a hiatus in the distribution of Lilly's other etesevimab treatment, as well as its combination of the two monoclonals, as neither worked as well against the Gamma and Beta coronavirus variants.

Can they prevent covid-19?

The antibody therapy manufactured by Regneron is also licensed for use as a preventive treatment, or what is known as post-exposure prophylaxis.

It can be given to someone who has been exposed to an infected person.

It can also be given to someone who is at high risk of exposure, such as people living in a nursing home who have had a recent case.

As prevention, mAbs are designed for use in patients who are not fully vaccinated or in people who are not expected to develop an adequate immune response to a vaccine, such as people who have had an organ transplant and are immunosuppressed.

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Who can receive monoclonal antibody treatments for covid-19?

Treatments for people infected with COVID-19 are for non-hospitalized adults and pediatric patients 12 years of age and older who are at risk for severe COVID-19.

Monoclonal antibodies are designed to be used early in the course of the disease to prevent it from progressing.

A patient who is ill should receive treatment as soon as possible after diagnosis and within 10 days of the onset of symptoms.

Studies show that monoclonals don't seem to work when people are sickest and already in the hospital or on oxygen.

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How does someone access treatment?

Medications do not come in a single pill, so they would not normally be available in the average doctor's office.

But a doctor can prescribe them.

MAbs must be administered by infusion or, if the infusion causes a delay in treatment, Regeneron treatment can also be administered by four subcutaneous injections.

The infusion itself can take about an hour and then patients must wait for an observation period to make sure there are no side effects.

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How effective are the treatments?

Studies show that mAbs are very effective in preventing high-risk patients from developing severe COVID-19 symptoms.

In March, Regeneron announced that patients who received their treatment within 10 days had a 70% lower risk of hospitalization and death.

GlaxoSmithKline resulted in an 85% reduction in the risk of hospitalization or death in high-risk patients compared to placebo.

As a prevention tool, a Regeneron study showed 72% protection against symptomatic infection in the first week and 93% protection in subsequent weeks.

Among those who did have symptoms, those undergoing treatment cleared the virus faster and were ill for less time.

Are there any side effects?

Allergic reactions are unlikely, but possible.

A worsening of symptoms can also occur after treatment, according to the FDA.

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How much do the treatments cost?

The United States has spent more than $ 2 billion on monoclonal antibody treatment doses.

But as of now, the treatment is free for patients, although there may be an administration fee.

Are the treatments hard to come by?

For months, the government has tried to promote the use of mAbs.

However, the US Department of Health and Human Services said as of Aug. 6, the latest date for which it has figures, that only about half of the distributed supply has been used.

"Right now, there are a lot of products available for new and existing sites," an HHS spokesperson told CNN last week.

As coronavirus cases have risen recently, the US has seen a 1,200% increase in orders for monoclonal antibody treatments in the past month, according to the HHS.

Approximately 75% of the orders come from regions of the US that have low vaccination rates.

HHS also said it has seen a recent increase in the number of doctors using the treatments.

At the beginning of the year, the federal government had shipped thousands of doses to the states.

But many were left on the shelf due to the complicated logistics of administering the treatments.

During the pandemic, health officials have recognized that doctors do not always know as much about these treatments.

And patients have had to struggle to obtain them or drive long distances to find a center to administer them.

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What is the difference between mAbs and a vaccine?

However, the protection from antibody treatments does not last as long as a vaccine.

Typically, the treatment would only provide protection for about a month.

A vaccine takes a couple of weeks for the immune system to start providing protection, but monoclonal antibodies work right away.

If there is treatment for covid-19, why do we need vaccines or other prevention methods?

The treatments are not a cure and are not an option for all covid-19 patients.

"Antibodies are an important adjunct to treatment options, but it is not the way out of this pandemic," Wen says.

"There is only a small subset of patients who would qualify for monoclonal antibody treatment. Furthermore, it is resource-intensive and time-consuming to administer."

"The way out of this pandemic is through vaccination and preventive measures to prevent people from contracting covid in the first place."

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