Early results of antibody cocktail to treat Covid show promise

GURGAON: Hospitals that have administered Regen-cov, the antibody cocktail drug developed by Regeneron and Roche, to Covid patients have so far seen encouraging results.Of 24 patients that TOI is aware of who have received the experimental therapy at three Haryana hospitals – PGIMS in Rohtak and Medanta and Park in Gurgaon – 13 have so far tested negative.The drug – a cocktail of Casirivimab and Imdevimab, which are laboratory-made copies of antibodies produced in the body if one gets an infection – got emergency use authorisation in May in India, following a similar approval in the United States, where one of those who received the therapy was former US President Donald Trump. medium83261475The Haryana government had in May procured 590 vials from Cipla, Roche’s Indian partner, for distribution at state-run hospitals in six districts. Doctors at PGIMS Rohtak, the main state-run hospital, said a decision on a wider rollout of the therapy would be taken after a four-week observation period.But though the sample size so far is small, initial results have been heartening. The four patients who received Regen-cov at PGIMS in May have all since tested negative for Covid. Medanta has administered it to 18 patients, of whom eight have tested negative while Park hospital has given it to two patients, one of whom one has tested negative. The others, doctors said, remain in the recovery stage. Most of them had mild symptoms like cough and fever. Some experienced breathlessness. Several of the patients who have received the mix of the two monoclonal antibodies are 60-plus. For instance, the four patients treated with Regen-cov at PGIMS were three men, aged 86, 64 and 63 and a woman (83). Dr Dhruv Chaudhary, the nodal officer for Covid-19 in Haryana and a member of the expert committee for distribution of the monoclonal antibodies drug, said, “All four patients have recovered well. It's been two weeks since these four patients received the therapy and we are still monitoring them. We will monitor them for four weeks. It is too early to come to a conclusion.”Regen-cov is meant for mild to moderate Covid patients in whom the infection has a high risk of turning serious. “This is given to high-risk Covid patients. We administered the drug to two Covid patients at Park hospital last week,” said its CEO Dr PN Kakar. “In one patient, the result was very good. The second one is still on BIPAP. The patient who tested negative went home. The other patient is admitted to our hospital,” he added.Doctors said the monoclonal antibody cocktail is expected to shorten recovery time and significantly reduce the possibility of hospitalisation among “high-risk” patients. Among the aspects of treatment doctors are closely looking at is the drug’s effectiveness in patients with comorbidities, re-infection cases and in patients who have already developed antibodies.Dr Sushila Kataria, intensive care expert at Medanta, said the therapy reduces inflammatory response in patients by stopping virus duplication so that they do not suffer from second week complications of Covid, which are turning fatal for some patients. “None of the patients had any kind of reaction after the therapy so far,” said Dr Kataria. “Our team of doctors evaluates each case and then we decide if a patient can be given the monoclonal antibodies drug or not. We have so far given the drug to 18 Covid patients. All of them are at home and eight have tested negative. We have been encouraging people to get the drug and take precautions at home. We are not encouraging people to go for a negative test, but after 14 days of the drug, if there are no breathing issues and fever, then the patient is automatically considered negative,” she added.The drug is not meant for patients who are on oxygen support or have an underlying condition that makes them dependent on medical oxygen, according to doctors. At government hospitals, the therapy will be administered for free, officials had earlier told TOI. boxcontentWhat is an antibody cocktail?Casirivimab and Imdevimab are monoclonal antibody drugs that specifically target the spike proteins of SARS-CoV-2. They block the virus attachment and entry into human cellsWho can get this therapy?* Mild to moderate patients with high risk of severe infection* Hospitals will use it as OPD therapy* Patients who receive the drug will be monitored daily* One vial can be used for 2 patients* After opening, vial has to be stored at 2-8°C and should be used within 48 hoursWho can't get this therapy?* Patients who are hospitalised* Patients in need of oxygen or those with an underlying condition that makes them dependent on oxygen