Recent Data Suggests More People With COVID-19 Would Benefit From Monoclonal Antibodies

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Key Takeaways

  • Monoclonal antibody treatment may prevent hospitalization in COVID-19 patients with a risk of severe disease—but this type of treatment has been difficult to come by.
  • New manufacturer research shows the available monoclonal antibody treatments are even more effective than previously thought.
  • Speed is important. To be effective, this type of treatment should be started within just a few days of symptom onset.

While the use of monoclonal antibody treatments for COVID-19 is quite limited, newly-published data on two types of these treatments is encouraging experts to update their recommendations.

Currently, the Infectious Diseases Society of America (IDSA) recommends against the routine use of the monoclonal antibodies and the National Institutes of Health (NIH) has said that there isn’t enough data to recommend for or against the treatment. But after the two companies that make the drugs issued press releases on new studies in late January, the IDSA held a webinar for physicians to evaluate the new data.

“This is a rapidly evolving field,” Rajesh Gandhi, MD, professor of medicine at Harvard Medical School and an infectious disease specialist, told the webinar participants.  

What Are Monoclonal Antibodies?

Monoclonal antibodies (MABs) are laboratory-made versions of antibodies the body makes naturally to fight invading pathogens like SARS-COV-2, the virus that causes COVID-19.

In November 2020, the Food and Drug Administration (FDA) granted emergency use authorization (EUA) to both bamlanivimab, made by Eli Lilly, and for the combination of casirivimab and imdevimab made by Regeneron, for non-hospitalized patients with mild to moderate COVID-19 who are at high risk for severe disease because of other health issues. The authorizations were based on interim findings that showed these drugs reduced COVID-19-related hospitalizations and emergency room visits. 

EUAs are not drug approvals. They are authorizations that can be granted only during a public health emergency—like COVID-19—that permit certain drugs to be used based on some testing. EUAs do not demand as complete research findings as FDA approvals. 

Despite the November EUAs, the monoclonal antibody treatments have not been widely used, both because of tepid support from medical organizations and because the drugs can be hard to find.

What's New?

The press releases that Regeneron and Eli Lilly shared in late January—which had not been reviewed by outside scientists when they were released—showed even more encouraging results than the studies submitted for the EUAs. 

Eli Lilly announced that their treatment reduced the risk of hospitalizations or death by 70% in newly-diagnosed COVID-19 patients who were not hospitalized. Ten deaths occurred, but they were in the patients who received a placebo.

Regeneron’s news release said that housemates of people in a clinical trial who had received the Regeneron monoclonal antibodies were less likely to develop COVID-19 than people in the trial on a placebo. 

The new data could help rev up interest and acceptance surrounding monoclonal antibodies. Because they are already FDA-authorized, they can be accessible (with a prescription) to patients outside of clinical trials.

At the IDSA webinar, Gandhi said there's still a lot we don't know yet, like the optimal timing to receive monoclonal antibody treatment, and how COVID-19 variants may change the effectiveness of these drugs.

Patient Story

In November 2020, Zelda Rosenthal, 86, began having breathing problems. A friend she had spent time with a few days before tested positive for COVID-19. Rosenthal’s daughter arranged for a rapid test and the technician told them about the monoclonal antibodies, which had just received emergency use authorization a few days before.

The family reached out to Rosenthal’s physician for a prescription, and she had an infusion that evening at Jackson Memorial Hospital in Miami, Florida. The hospital had only just received their monoclonal antibody supply.

Following treatment, Rosenthal's condition did not worsen.

"If it’s the drug that helped, it should be easier to track down,” her daughter tells Verywell. 

Who Should Be Considered For Monoclonal Antibody Treatment?

The basic eligibility criteria for monoclonal antibody treatment, according to a recent fact sheet from the American College of Emergency Physicians, includes: 

  • The patient is positive for COVID-19
  • The patient is age 12 or older 
  • The patient is at high risk for severe disease or hospitalization based on risk factors such as as heart disease, obesity, and diabetes
  • It has been 10 days or less from the start of COVID-19 symptoms

Blockers to Treatment

While the latest research about the effectiveness of available monoclonal antibodies is a good thing, it's still fairly difficult to pursue this treatment method.

The drugs, at least for now, can only be given as intravenous infusions in a hospital or clinic setting. Some hospitals, overwhelmed by caring for COVID-19 patients, haven’t been able to spare staff or space to set up the clinics, Jason Gallagher, PharmD, clinical professor at Temple University School of Pharmacy, tells Verywell.

People who think they will benefit from monoclonal antibodies will also need a prescription. According to Brian Nyquist, MPH, executive director of the National Infusion Center Association, patients and/or caregivers need to be proactive in order to secure a prescription:

  • If you test positive for COVID-19, ask the testing site if they have a doctor on staff who can write the prescription, which may be faster than reaching out to your own doctor. 
  • If not, reach out to your own doctor or ask the testing site if they have a doctor they can refer you to for a consult on monoclonal antibody treatment.
  • If you don’t have a prescription but have located an infusion center that has the drugs on hand, ask if they have a doctor that can prescribe the drugs. (Some infusion sites are staffed by nurses who are proficient at infusions but may not be able to write the prescription for the treatment.) 

What This Means For You

If you have COVID-19 symptoms or a recent test that shows you are positive, ask your doctor if you might be eligible for monoclonal antibody treatment. If you do receive monoclonal antibody treatment, you will have to wait 90 days before getting a COVID-19 vaccine. That’s because the antibodies from the treatment may interfere with your body’s antibody response to the vaccine.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.

2 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Infectious Diseases Society of America. Monoclonal Antibodies. COVID-19 Real-Time Learning Network.

  2. COVID-19 Guidelines: Therapeutic Management of Patients with COVID-19. National Institutes of Health.

By Fran Kritz
Fran Kritz is a freelance healthcare reporter with a focus on consumer health and health policy. She is a former staff writer for Forbes Magazine and U.S. News and World Report.