Monoclonal Antibody Cocktail Shows Promise in Fight Against COVID-19

Overview

Covid-19 has been a nightmare for the entire world. But the good news is, even with the progression of the epidemic and the corresponding new waves, medical science has significantly protected mankind. We now have many more drugs, not to mention vaccines. Many companies worldwide are researching the virus and producing medications and vaccines.

Roche, a Switzerland-based pharmaceutical company, launched an antibody cocktail worldwide to fight the Sars COV 2 virus that causes COVID-19. Recently, Central Drugs Standards Control Organisation (CDSCO), the Indian drug regulator, granted emergency use authorization (EUA) to this antibody cocktail in India. The drug, marketed by CIPLA in India, will be available pan-India from May 24, 2021.

This antibody cocktail is a combination of two monoclonal antibodies: Casirivimab and Imdevimab. Both Imdevimab and Casirivimab are human immunoglobulin G-1 (IgG1) monoclonal antibodies that act against SARS-CoV-2 (the virus that causes COVID-19) spike protein. The antibody cocktail  thwarts the attachment of the virus and its entry into the human cell.

Stated for emergency use authorization (EUA), the cocktail antibody is said to have the potential to treat mild-to-moderate Covid-19 infection in adults and patients above 12 years of age who are at a higher risk of developing severe disease and do not need oxygen.

How does the Monoclonal Antibody Cocktail Work

Monoclonal antibodies are proteins that mimic the ability of our immune system to fight off harmful pathogens like viruses. The product is directed specifically against the spike protein of SARS-CoV-2, designed to block the attachment and entry of virus into human cells.

Antibodies are the defence mechanism of our body against the virus. Sometimes, you might not have adequate antibodies to fight the organism.

So, in this case, we supplement the antibodies produced in our body with additional antibodies from the laboratory. It works against the virus’s spike protein, preventing the virus from further replication (neutralization). Thus, the virus cannot cause further harm to our bodies.

Who are the candidates, and which age groups are suitable for monoclonal antibody cocktail drug?

Monoclonal antibody cocktail can be given for the treatment of mild-to-moderate COVID-19 in adults and children above 12 years who are at high risk of developing severe COVID-19 infection and/or hospitalization with at least one of the following criteria:

1. Diabetes
2. Chronic kidney disease
3. Obese (body mass index less than 35)
4. Immunocompromising condition
5. Currently getting immunosuppressive treatment
6. People aged over 65 years
7. People aged above 55 with:
8. Cardiovascular disease
9. Hypertension (High Blood Pressure)
10. COPD (Chronic obstructive pulmonary disease) or other chronic respiratory disease

This drug has been recommended only for patients above 12 years. It covers the elderly above the age of 60. It is not recommended for infants and children below 12 years. If your child is 12 years or above, he/she must weigh at least 40 kg to be eligible for the antibody cocktail.

There is no exception for any age group. Any eligible age group must have the additional comorbidities as additional risk factors for the possible complications from a COVID-19 infection.

Where is the Antibody Cocktail Available and How is it administered

The Antibody Cocktail (Casirivimab and Imdevimab) is currently available as a therapy to treat COVID patients with mild and moderate infection at Apollo Hospitals. This is available only after a qualified doctor’s prescription. The doctor will evaluate and asses for COVID -19 severity before deciding if any patient is suitable for the therapy.

The cocktail is administered only once in a specific area with well-trained healthcare personnel intravenously. Antibody cocktail should ideally be administered within 48 to 72 hours of a COVID-19 infection and before seven days.

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The risk factors categorized as qualifying factors for the shot

Your doctor will take your detailed medical history to see if you are eligible for this medication. Tell your doctor your exact medical history as we do not know the repercussions of manipulated history. The conditions you should highlight to your doctor are:

• Ongoing dialysis
• Diabetes
• Cardiovascular problems
• Immunocompromised states

In these cases, your body mostly will not be able to produce adequate antibodies, and an external source might be required.

Advantages of taking Monoclonal Antibody Cocktail

If you qualify for the cocktail (only your physician can decide), you will be administered the antibody. You need to take only a single dose of this antibody. The therapy has said to have reduced the risk of hospitalization by 70 per cent and fatality rate by 71 per cent and shown to have shortened the duration of symptoms by four days.

Is Antibody Cocktail useful in the treatment of COVID-19 infection?

This advanced Antibody Cocktail therapy comprises of neutralizing monoclonal antibodies for patients suffering from COVID-19 infection. Monoclonal antibodies ‘neutralize’ and bind to the SARS-CoV-2 virus. This treatment option can boost the efforts to bring the pandemic under control significantly and may help prevent the progression of this deadly disease in those with mild to moderate COVID-19 infection.

Antibody cocktail contains a mixture of more than two biological drugs (Casirivimab and Imdevimab) that mirror human antibodies in our immune system, which thus help fight the infection.

Both the antibodies also strengthen our immune defence system. This antibody cocktail is said to limit pathogens and viruses from entering the patient’s body, from where they would have otherwise derived nutrition and multiplied. This drug will help prevent the progression of the disease to a severe stage

It is one of the very few recommended treatments for COVID-19 at this time. This antibody is used to avoid major complications that lead to hospitalization and death in COVID-19 infected individuals. It only works if you are mild to moderately symptomatic. It is also important that you have a high-risk profile for developing complications like diabetes, an immunocompromised state, etc., to be eligible for this treatment.

Prevention is better than cure

It is the collective responsibility of every individual to comply with the COVID-19 prevention guidelines and maintain discipline. No matter the number of drugs in the market and the number of healthcare experts available to attend and treat you, this epidemic requires self-discipline.

Individual responsibility is of paramount importance . You need to adhere to all the preventive guidelines. You must follow:

• Social distancing in public with at least a distance of one meter between two people
• Wearing a mask when outside.
• Washing hands often with an alcohol hand wash or sanitizers.

Avoiding gatherings, especially in closed spaces.

Frequently Asked Questions (FAQs) 

Q. How does this work?

This antibody cocktail helps your body fight the coronavirus. It allows your body to restrict progress into a severe state of infection.

Q. What is the ideal time to administer this antibody? 

Antibody cocktail should ideally be administered within 48 to 72 hours of a COVID-19 infection and before 7 days

Q. What is the limitation of this medication? 

Certainly, the price of the medication is a limitation, especially in India. Currently, it is priced at Rs. 59,750/- per dose of antibody, even with differential pricing. The good thing is, only a single dose is enough.