Your Health Questions Answered

Where Have Covid-19 Antibody Treatments Gone?

Most monoclonal antibody treatments have been de-authorized or restricted by the FDA. Why are they gone, and what has replaced them?

By Allison Forsyth May 4, 2022

Covid-19 antibody test.

Covid-19 antibody test.

Image: Kari Perrin

Early in the pandemic, experts told us monoclonal antibody treatments were highly effective against Covid-19. The treatment showed promise for those with severe cases of the virus, keeping them out of the hospital and expediting recovery.

Then Omicron came on the scene. The highly contagious variant and its BA.2 sub-variant spread like wildfire and became resistant to monoclonal antibody treatments, causing the FDA and the Biden Administration to reconsider the treatments' use at the beginning of 2022.

In January, the FDA restricted the use of two major treatments: Regeneron and Eli Lilly. "Data shows these treatments are highly unlikely to be active against the Omicron variant, which is circulating at a very high frequency throughout the United States," the FDA said in a press release.

Another treatment, a drug called Sotrovimab, has also been de-authorized to treat Covid-19 in any U.S. region due to increases in the number of cases caused by the BA.2 sub-variant.

So, where does that leave monoclonal antibody treatments now? In Florida, they're offered at select locations and for those most at risk of hospitalization and death from Covid-19.  Florida Gov. DeSantis and Surgeon General Dr. Joseph Ladapo also continue to back this treatment as a viable, life-saving option despite its de-authorization by the FDA.

Are monoclonal antibody treatments still effective?

Not really, but there's more to it. According to the CDC, monoclonal antibody treatment methods have been ineffective at treating the most current and dominant strain of Covid-19, which is the Omicron BA.2 sub-variant. While they worked for a time against the original strain and Delta variant, the numbers of these strains circulating are low compared to Omicron.

Are treatments still available?

The National Institute of Health recommends using the treatment bebtelovimab, which is 175 milligrams of intravenous injection given to patients ages 12 and older one time, but only when the Pfizer drug Paxlovid is not available in your area or clinically appropriate. Bebtelovimab is the only option available within the state of Florida at this time.

Bebtelovimab treatment is started as soon as a case is confirmed with an antigen or PCR Covid-19 test, or within seven days of symptom onset.

Who qualifies for these treatments?

Bebtelovimab must be prescribed by a healthcare provider in order for a patient to receive it. You must also have a positive antigen or PCR Covid-19 test to determine whether you are eligible. Patients over the age of 50 or who are considered immunocompromised are more likely to benefit from the treatment.

Where can you get these treatments locally?

According to an automated message on Sarasota Memorial's monoclonal antibody information hotline, "due to a statewide shortage of supplies, monoclonal antibody treatments are limited in the Sarasota-Manatee area. Treatments are by appointment-only at Sarasota Memorial Hospital, and only for the most immunocompromised in our community, such as those undergoing cancer treatment, those with autoimmune diseases and those who are pregnant."

If monoclonal antibody treatment is limited, what are other treatment options against Covid-19?

Our region's case numbers may be low, but there are still members of our community contracting the virus. Pfizer's antiviral drug, Paxlovid, is widely available at pharmacies throughout the state with a physician's prescription.

Paxlovid is a two-drug system that has an 89 percent reduction in the risk of hospitalization and death in clinical trials that supported its emergency use authorization by the FDA. The drug is taken twice daily for five days, within five days of symptom onset. In order to get a prescription, you must have a positive Covid-19 antigen or PCR test and be 12 years old or older.

For a list of where to find Paxlovid in Sarasota-Manatee, click here.

Is monoclonal antibody treatment a substitute for Covid-19 vaccination?

In a word: no.

While antibody treatment aids patients who've already contracted Covid-19 and are in the midst of illness, vaccination is recommended as prevention for Covid-19.

If you have already received monoclonal antibody treatment over the course of this pandemic, you can still get vaccinated. The CDC recommends you wait 90 days after treatment before vaccination.

For a list of vaccination sites in Sarasota-Manatee, click here.

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