BENGALURU: Monoclonal antibodies, a single-shot drug cocktail given to former US President Donald Trump against Covid, is gaining popularity in Karnataka, as doctors and patients vouch for its effectiveness in preventing deaths. Manipal Hospitals in Bengaluru alone has administered this drug on more than 80 patients, and seen all of them recover.
However, researchers call for more such drugs so they become affordable. “I have myself administered this miracle drug on nearly 80 patients, and have seen all of them recover in 24-48 hours. It is unfortunate that this drug was not available during the peak of the second wave, or we would not have seen so many hospital admissions or deaths among those who could afford this treatment,” said Dr Sathyanarayana Mysore, pulmonologist, Manipal Hospitals.
Last November, the US FDA issued emergency use authorisation to REGEN-COV, which contains two monoclonal antibodies — casirivimab and imdevimab — to be administered together for treating mild to moderate Covid patients. India granted emergency use authorisation in May. Therapy is directed against the spike of protein of SARS-CoV2.
“I have treated 4-5 patients. It reduces the chances of hospitalisation by 70% in patients with mild to moderate symptoms. The cocktail blocks the virus’s attachment and subsequent entry into human cells,” said Dr Sanjay Gururaj, consultant physician, Shanti Hospital and Research Centre.
A pack of REGEN-COV contains one vial of casirivimab (1200mg) and one vial of imdevimab (1200mg) and is priced at Rs 1.19 lakh. One pack can be used for two patients, thus the cost per patient comes to Rs 59,750. Some doctors have refrained from using this due to the cost. However, Dr Sathyanarayana says, “If the medicine is prescribed at the right time, the patient can be saved from the stage of needing oxygen and ICU bed, which cost more than what the medicine does.”
Meanwhile, a few doctors don’t want to administer this as it has been used only on an experimental basis. Dr Shashikiran Umapathy of Manipal, Udupi, says, “We stick to anticoagulants and medicines which we have used in the first wave, and seen good success rate, including Remdesivir.”
At a recent webinar organised by Centre for Science and Environment, Chief Scientist, World Health Organisation, Soumya Swaminathan said while the world had moved fast on vaccines, not much was being done on the therapeutics front for Covid. “There are no antivirals, as such, and not many drugs that can be prescribed for patients in the early stage of Covid. All we have is a set of two drugs — corticosteroids and interleukin-6 blockers — for severe patients. Monoclonal antibodies may be given to patients before reaching the severe stage, but it is a costly cocktail of treatment,” she said.
WHO CAN BE GIVEN THE DRUG, AND WHEN?
Earlier the better, mostly on Day 5 of onset of symptoms. Has been given up to 10 days too
Patient should be at risk of progressing to worse symptoms, onset of cytokine storm
Aged above 65, in most cases. Technically, anyone above 14 can be given
‘At risk’ people -- those with neurological illness, taking immunosuppressives, have coronary artery disease, renal issues, malignancy etc Oxygen level should not be at risk
Can be even given as day care treatment
Patient should come to hospital with RT-PCR positive report within 72 hours, for maximum benefit
What are monoclonal antibodies?
When our bodies are
attacked by an infection caused by viruses or bacteria, they produce natural antibodies or proteins to fight back. These antibodies are crucial in our immune system’s defence
mechanism. Monoclonal antibodies are similar to natural antibodies, except they are laboratory-made. They are designed to target a specific disease and are often referred to as ‘designer antibodies’.