Antibody Cocktail treatment during Covid-19: Here’s everything you need to know about it

By Dr. BS Ajai Kumar, 

With COVID-19 engulfing all of us mentally, physically, and socially, there has been an additional responsibility on drug makers to find innovative and fresh solutions that work for the well-being of people including, of course, the vaccine. Drug makers have done their best so far. While we work towards ensuring that everyone is vaccinated, there are certain immediate therapies needed that could possibly delay the negative effects of COVID-19 on the human body.

Recently, there has been a lot of positive chatter post the announcement and release of the monoclonal antibody cocktail treatment in India. It is seen as a game changer in the present context and could possibly be THE solution that the healthcare community is seeking. Monoclonal Antibody Cocktail treatment is not new and has been enlisted as one of the treatment options that the natural immune system functions to fight cancer.

These laboratory-produced engineered molecules are designed to serve as substitute antibodies that can restore, enhance or mimic the immune system’s attack on cancer cells. This antibody cocktail treatment helps reverse the cancer and save patients’ lives.

This is a good breakthrough in unprecedented times. With this taking centre stage, the least we want to achieve is to eliminate the fear of Covid and specially help the treatment of cancer patients.

Here is what we must know and understand:

• High risk patients are those of and over 60 years of age with co-morbidities like obesity, diabetes or with severe cardiovascular, lung, kidney, liver diseases, immunosuppressed, i.e. cancer treatment, bone marrow or organ transplantation, immune deficiencies, HIV (if poorly controlled or evidence of AIDS), sickle cell anemia, thalassemia, and prolonged use of immune weakening medications.
• A combination of neutralizing antibodies, Casirivimab and Imdevimab have been approved for restricted emergency use by the Indian regulatory authority, CDSCO, for the treatment of mild to moderate COVID-19 in adults and pediatric patients with laboratory confirmed covid-19 infection and are at high risk of severe COVID-19 – at the risk of hospitalization.
• This cocktail is effective in reducing hospitalization in around 70 % of eligible candidates (12 years and above, weighing at least 40 kg, who are not hospitalized patients and do not require oxygen supplementation) when administered within 7 days of onset of the symptoms.
• It is safe for patients with chronic kidney disease, chronic liver disease, and immunosuppressed individuals without significant side effects. It is a good alternative in view of its safety profile and no role in immunomodulation.
• Casirivimab and imdevimab should be given together after confirmation of infection, within 10 days of symptom onset. Data shows that it works best within 3 days of symptom onset, and efficacy upto 7 days from symptom onset.
• The EUA (emergency use authorisation) approval is upto 10 days. The efficacy correlates with high viral load that usually present upto first 5 days of symptom onset. As per recent trials, doses of 600 mg of Casirivimab and 600 mg of imdevimab are recommended in India. The newer trials have also used the subcutaneous dosing method as an option. This provides the opportunity to administer the medicine easily, potentially even at home.
• Possible side effects include reactions such as fever, difficulty breathing, chills, fatigue, discomfort, weakness, nausea, headache, throat irritation, rash etc. Severe hypersensitivity reactions have been reported rarely.
• The cocktail is known to stand against variant strains of UK, South Africa, Brazil, New York, and California origin

Prevention is the key – if the patients get the cocktail drug at the right time, it is possible to prevent severity / hospitalization especially in chronic cases. With the current situation where we are strapped for resources, we must do everything that delays or prevents a chronic state in patients affected by covid-19 and help check the burden on the healthcare sector and families.

(The author is Executive Chairman and CEO of HCG. He has been awarded the Ernst and Young Entrepreneur of the Year Award, the CII Regional Emerging Entrepreneurs Award, and the BC Roy Award by the Indian Science Monitor. He is also a recipient of the Karnataka Rajyotsava Award. The article is for informational purposes only. Please consult health experts and medical professionals before starting any therapy or medication. Views expressed are personal and do not reflect the official position or policy of the Financial Express Online.)