What you Need to Know About Monoclonal Antibody Treatment for COVID-19
Antibodies cultured in the lab can help the immune system tackle the coronavirus. However, they are not and will never be a substitute for the vaccine.
There’s a continuous surge in COVID-19 cases in the United States, followed by a spike in the demand for monoclonal antibody treatments, especially in areas where the vaccination rate is very low.
According to the FDA, this treatment employs “lab-made proteins that mimic the ability of the immune system to fight harmful antigens like SARS-CoV-2 and other viruses.
It is very useful for people whose immune system is weakened who may be unable to generate a robust response to the vaccines, as well as for people with a risk of severe illness.
Although monoclonal antibodies may clear the virus within hours of intravenous infusion, this treatment may not work for everyone.
As such, experts recommend full vaccination against COVID-19, which prevents hospitalization and severe illness due to the disease.
How monoclonal antibodies work
A monoclonal antibody is a protein produced in the lab. It works like antibodies produced by the immune system when there’s an infection.
A monoclonal body binds to a specific molecule on a bacteria or virus. This molecule to which it binds is known as an antigen. Through this binding action, a monoclonal antibody can restore or enhance the immune response against these pathogens.
It is important to note that monoclonal antibody treatment has been used for the respiratory syncytial virus as well as the Ebola virus. It has also been tested for chronic illnesses such as multiple sclerosis, rheumatoid arthritis, inflammatory bowel disease, etc.
Medical researchers and clinicians are creating monoclonal antibodies that target cancer cells. Medical researchers and scientists sometimes create monoclonal antibodies by isolating specific immune cells – known as B cells from an individual who has recovered from an infection.
The isolated B cells are used to recreate monoclonal antibodies in a lab. The antibodies may be mass-produced and administered to people via an IV.
Here’s what you should know. A monoclonal antibody targets a unique antigen on a bacteria or virus. As such, this treatment isn’t the same as convalescent plasma, which contains several antibodies that target a wide range of antigens.
It is important to note that most monoclonal antibodies target the spike protein on the COVID-19 virus, which the coronavirus uses to access the host cells.
When it binds to the spike protein, the monoclonal antibody can then prevent the virus from infecting cells in the human body.
Studies have shown that some monoclonal antibodies can reduce the risk of hospitalization and mortality in mild or asymptomatic COVID-19 cases.
Researchers are examining this treatment to determine whether it can reduce the risk of transmitting COVID from an infected person to others within their environment.
Who can get treated with monoclonal antibodies?
The FDA has issued emergency use authorization to several monoclonal antibodies.
- Sotrovimab: This is for use in adults and kids over the age of 12
- REGEN-COV: This is a drug cocktail containing two monoclonal antibodies, imdevimab and casirivimab. It should be used by people who are over 12 years of age.
- Bamlanivimab & etesevimab: In June 2021, the government of the United States paused the distribution of both monoclonal antibodies. Why? Well, tests revealed that both antibodies were inactive against the Beta and Gamma variants of the coronavirus. The FDA advised that health professionals use other monoclonal antibodies.
The FDA has also authorized the use of Actemra (tocilizumab) for COVID-19 treatment in adults and children (2+ years) that have been hospitalized. This antibody has anti-inflammatory functions. It reduces the inflammation that is typical of COVID-19.
All the antibodies listed have received emergency authorization for the treatment of COVID-19 (mild to moderate) in people over the age of 12 who tested positive for the virus and are at high risk of the disease (COVID-19).
People in this category include those with weak immune systems, pregnant people, older adults, as well as people that are obese, diabetic, or have other chronic diseases.
Although monoclonal antibodies can reduce the risk of illness in the above category of people, full vaccination is important as well.
A monoclonal antibody is usually administered within 10 days of a positive test. Administering the monoclonal antibodies relatively soon in patients with high risk may be impactful in some way.
Regeneron’s cocktail has been authorized for emergency use in people that are at high risk of severe COVID-19 – people who were exposed to the virus, but haven’t tested positive or developed any symptoms.
This helps in situations where a person who hasn’t been vaccinated is exposed to COVID-19.
With both mRNA vaccines, full protection does not occur until at least 2 weeks after getting the second dose. There’s a very high possibility that people may already be ill by then.
According to the CDC, people who have had COVID-19 should get a vaccine. Studies have shown that vaccination improves immune response compared to natural infection alone.
Marovich M, Mascola JR, Cohen MS. Monoclonal Antibodies for Prevention and Treatment of COVID-19. JAMA. 2020;324(2):131–132. doi:10.1001/jama.2020.10245
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