In-Depth: How antibody treatments for COVID have evolved and where to find them

Monoclonal antibodies
Posted at 5:14 PM, Mar 26, 2021
and last updated 2021-04-18 21:42:21-04

SAN DIEGO (KGTV) -- Across California, there are now more than 475 locations offering monoclonal antibody treatments, a type of drug that doctors say has evolved into the most effective life-saving therapy for COVID-19 following a shaky initial rollout.

Clinics in San Diego County started receiving the latest version of these laboratory-made immunity molecules last week: a cocktail of two antibodies from Eli Lilly re-tooled for variants like B.1.427 and B.1.429, both first detected in California.

“This is by far the most effective intervention in terms of therapy for COVID-19 that we've ever had,” said Dr. Christian Ramers of Family Health Centers of San Diego. “Way more effective than remdesivir or corticosteroids. And it's upstream, so you take somebody who is just newly diagnosed and you can prevent that hospitalization.”

FHCSD was among the first clinics in San Diego County to offer monoclonal antibodies. They have now infused about 150 people, Ramers said.

The federal government paid $210 million for 100,000 doses of Eli Lilly’s latest antibody cocktail, meaning each dose cost $2,100. The Biden Administration says it could purchase an additional 1.2 million by the end of the year.

The therapies are offered to patients free of charge, although individuals must fall into a high-risk category and seek out a dose within 10 days of their initial symptoms. They are intended for people with mild to moderate symptoms who are not hospitalized.

The full list of qualifying conditions appears below or can be found here.

There are now at least 18 sites offering the antibody treatments in San Diego County, with a new site planned to open in the South Bay next month. The locations are available here.

Monoclonal antibodies are manufactured versions of one of the key immune molecules our body produces after vaccination, but they’re engineered to be especially effective at binding to a virus and disabling it. While vaccines take several days to ramp up our cells and produce antibodies, monoclonals are ready to patrol the body shortly after they’re infused.

The treatments were first authorized in November, but got off to a rough start.

Thousands of doses sat in storage during the winter surge because overwhelmed hospitals didn’t have the staff or space. The first drugs took an hour to infuse, further straining resources.

Eli Lilly’s first-generation monoclonal antibody, bamlanivimab, was found to be ineffective against the California variant.

But all of that has begun to change.

“There were a lot of skeptics about monoclonal antibodies because the evidence really wasn't there, but in the last couple of weeks we've seen a couple really good tranches of evidence,” Dr. Ramers said.

This month, another manufacturer, Regeneron, released results from a Phase 3 study showing its antibody cocktail reduced the risk of hospitalization and death by 70 percent.

Eli Lilly shifted from its initial one-drug formula to a two-drug cocktail to address variants, and found it cut the risk of hospitalization and death by 87 percent.

The FDA has shortened the infusion time from one hour to about 20 minutes. (Patients still have to remain at a clinic for one hour after the infusion for observation.)

Last week, the Biden Administration announced it will spend another $150 million to expand access in low-income areas.

“Where I think this is headed is to make this really the new standard of care for COVID-19 in the U.S.,” Ramers said.
Family Health Centers has been in talks with the federal government about getting one of the grants, according to Ramers, which would allow them to infuse 40 people each week, up from 20.

Who qualifies for monoclonal antibodies?

High risk is defined as patients who meet at least one of the following criteria:

  • Have a body mass index (BMI of 35 or more)
  • Have chronic kidney disease
  • Have diabetes
  • Have immunosuppressive disease
  • Are currently receiving immunosuppressive treatment
  • Are 65+ years of age
  • Are 55+ years of age AND have
    • cardiovascular disease, OR
    • hypertension, OR
    • chronic obstructive pulmonary disease/other chronic respiratory disease.
  • Are 12 – 17 years of age AND have
    • BMI ≥85th percentile for their age and gender based on CDC growth charts, OR
    • sickle cell disease, OR
    • congenital or acquired heart disease, OR
    • neurodevelopmental disorders, for example, cerebral palsy, OR
    • a medical-related technological dependence, for example, tracheostomy, gastrostomy, or positive pressure ventilation (not related to COVID-19), OR
    • asthma, reactive airway or other chronic respiratory disease that requires daily medication for control.