Monoclonal Antibody Therapy
What Is Monoclonal Antibody Therapy?
Who Is Eligible to Receive It?
Where Can I Receive this Therapy?
North Country Healthcare (NCH) clinicians have a treatment to help prevent severe symptoms from developing in those who are at high risk of acquiring COVID-19. Recently, the Food and Drug Administration (FDA) extended the potential application of monoclonal antibody therapy for preventive use in those at risk due to a confirmed exposure to the virus. The authorization was based on the results of a large clinical trial which found that the antibodies prevented symptoms in household contacts of people who recently tested positive. The FDA stressed that the therapy is not a substitute for vaccination, however.
What Is Monoclonal Antibody Therapy?
Antibodies are part of our natural defense against viruses such as SARS-CoV-2, the virus that causes COVID-19. However, time is required for the body to create such antibodies. A monoclonal antibody is a laboratory-produced protein that functions like the antibodies made 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. They have been shown to reduce the risk of progressing to severe COVID-19 and hospitalization when given early to people who test positive for COVID-19.
Who Is Eligible to Receive Monoclonal Antibody Therapy?
Monoclonal antibody treatment needs to be given within ten days of the start of symptoms.
Monoclonal antibody treatment is available to individuals who are at high risk* of developing severe COVID-19
AND who have had a positive COVID-19 test
AND who have not yet been admitted to the hospital
AND are 12 years of age or older (and at least 88 pounds)
*High risk includes any of the following:
- At least 65 years old
- A BMI of more than 25 kg/m2, or if age 12-17, BMI above the 85th percentile for their age and gender, based on CDC growth charts
- Currently pregnant
Post-exposure preventive monoclonal antibodies are also available to those who have been exposed (consistent with the CDC's close contact criteria**) and possess one or more of the following:
- Chronic kidney disease
- Cardiovascular disease (including congenital heart disease, hypertension)
- Down syndrome
- Liver disease
- Chronic lung disease (COPD, moderate to severe asthma, cystic fibrosis, pulmonary hypertension)
- Sickle cell disease
- Immunosuppressive disease or receiving immunosuppressive treatment
- Neurodevelopmental disorders or other conditions that confer medical complexity (severe congenital anomalies, cerebral palsy)
- Have a medical-related technological dependence (tracheostomy, gastrostomy)
Other trial-represented conditions to consider:
- Current or former smoker
- History of stroke or cerebrovascular disease
- Current or history of substance abuse
**In some cases, direct exposure isn't a criteria.
Can I Receive Monoclonal Antibodies Treatment If I Already Received the COVID-19 Vaccine?
If you already received one or both doses of the vaccine and you are eligible, you can receive this treatment.
Why Would I Consider Receiving a Monoclonal Antibodies Infusion?
An infusion / injection may minimize the potential for higher risk patients to progress to severe disease and/or hospitalization. If you believe that you would be an appropriate candidate for these therapies, please contact your medical provider to see if an infusion / injection is right for you. Monoclonal antibodies should not be considered the standard of care for the treatment of all patients with COVID- 19.
How Effective Are Monoclonal Antibodies?
According to a study from the New England Journal of Medicine, early clinical data show that monoclonal antibodies can successfully reduce COVID-19 hospitalization rates. Clinical trials have shown that these treatments can decrease hospitalizations and emergency department visits. They can also reduce the amount of virus found in an infected person's blood. Patients who received monoclonal antibodies found that the treatment has significantly cut the risk of hospitalization and death from COVID-19. Health officials continue to monitor the safety and effectiveness of the treatments. Clinical trials are ongoing. It isn't yet known if monoclonal antibodies protect against future COVID-19 infections.
How Are Monoclonal Antibodies Administered?
Monoclonal antibodies are administered by health care professionals through an intravenous (IV) infusion or through a shot (subcutaneous injection), if qualified. The infusion takes anywhere from 50 to 60 minutes to complete, followed by 60 minutes of observation by one's health care provider.
What Are the Side Effects of Monoclonal Antibodies?
The most common reported side effects for casirivimab/imdevimab are:
- Pneumonia IV infusions can also cause brief pain, bleeding, skin bruising, soreness, swelling, and infection at the infusion site.
Does Receiving Monoclonal Antibody Therapy Mean That I Can Cut My Isolation Short?
NO. Anyone who has tested positive for COVID-19 needs to isolate - regardless of whether or not he or she has received monoclonal antibody therapy. This means staying in your home and away from other household members for:
Ten days since testing positive
Ten days after symptoms first appear AND At least 24 hours after your symptoms have improved and you've been without fever (without the use of fever-reducing medications)
Only after meeting the above criteria can you return to work and leave your home (while still social distancing and wearing a mask).
Where to Get Monoclonal Antibody Infusion Therapy
Please contact your medical provider. Monoclonal Antibodies are available by appointment at:
- Androscoggin Valley Hospital
- Upper Connecticut Valley Hospital
- Weeks Medical Center
What is the Cost of Treatment?
Monoclonal antibodies are free. Insurance covers the cost of treatment. If you are uninsured, your healthcare provider will be reimbursed from federal funds.
When Can I Receive a COVID-19 Vaccine?
After receiving monoclonal antibody therapy, it's recommended that you wait 90 days before receiving the COVID-19 vaccine. If you already received the first dose of vaccine before monoclonal antibody therapy, current CDC guidelines recommend you wait 90 days before receiving the second dose.