Explained: Who should get monoclonal antibody therapy?

Talking about the monochlonal antibody cocktail therapy, Dr Shashank Joshi, a member of Maharashtra COVID Task Force on Thursday said that it is working against Delta variant of the COVID-19, but its data on Omicron is poor. He added that it has to be given to the most severe cases which are in the vulnerable groups.

“The monoclonal antibodies is working against Delta. Its data on Omicron is poor and it has to be given into the most severe cases which are in the vulnerable groups,” Dr Joshi told CNBC-TV18.

For starters, a 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 hospitalisation. It is approved at a combined dose of 1200 mg (600 mg of each drug) administered by intravenous infusion or subcutaneous route.

“People who are morbidly obese, diabetic, who have chronic kidney disease, who have organ transplants, survivors of bone marrow transplants or solid organ transplants, who have severe immune-compromised states, only those individuals, and it is a very small group, are eligible for monoclonal antibodies, and person is symptomatic. So unless and until one doesn’t fall into the category, it should not be given to everybody. If you are symptomatic, it definitely gives you relief. And remember, this works only on the Delta strain; the data on Omicron strain is poor,” Dr Joshi added.

“We are now in development of newer monoclonal lytic cocktail of antibodies from various companies, both from India and abroad, which will be available in the near future, which may have an impact on Omicron. So currently, as far as Omicron is concerned, probably, most people will recover whether you treat them or not, but we still need to be vigilant and maybe at an early age, antiviral may work but again as I said, it may work, we need to see that and test it if Delta strain is there,” he said.

On Molnupiravir, Dr Joshi said, “With the availability of Molnupiravir in Delta population, there might be a role if it is used in the first 48-72 hours because clearly there is a 30 percent drop in mortality and hospitalisation. I am certain that the Ritonavir-boosted therapy also may be available by various generic Indian companies very soon. So, those will be the options that will be far more effective again in the vulnerable population. So, remember monoclonal antibodies is, if your medical doctor feels that you are in a vulnerable group or comorbid group or in a severe group and you are likely to progress, then it is offered. So obviously there is no need to rush if your doctor feels you are reasonably okay, you can monitor yourself well at home and most omicron cases will recover on their own.”