Are monoclonal antibodies still effective in treating coronavirus? Docs discuss where treatment stands. – SILive.com

STATEN ISLAND, N.Y. A first-step treatment against COVID-19 previously hailed as lifesaving by top doctors on Staten Island has taken considerable blows as continued disease mutations effectively eliminated protections for nearly all versions of the therapy.

The treatments focus on the spike protein of the disease has proven to become an Achilles heel, as changes in COVID-19s genetic code most commonly alter at the location which binds to and infects healthy cells.

But one form of monoclonal antibodies bebtelovimab remains a viable tool in the boroughs battle against the pandemic and has shown ability to reduce symptoms by as much as three days, Dr. Theodore Maniatis, the chief medical officer of Staten Island University Hospital (SIUH), told the Advance/SILive.com.

SIUH in Ocean Breeze has been administering monoclonal antibodies to a few dozen people a week, said Maniatis, with its two weekly appointment dates, Tuesday and Friday, serving around 20 people each day.

Those numbers are around double the total observed at the hospitals infusion center, located at 348 Seaview Ave., three weeks ago. However, its also about one-third the total the facility was experiencing two months ago.

Basically, when the disease gets out there and people start coming down with this, they look for the treatment, said Maniatis, who added SIUHs infusion center has the capacity to handle about double the number of its current appointments.

A similar fluctuation tied to the prevalence of virus spread has been observed at Richmond University Medical Center (RUMC) in West Brighton, said Dr. Philip Otterbeck, chairman of medicine at the hospital.

He said RUMC maintains an adequate supply of bebtelovimab that is dependent on New York States allocation of the drug, which sometimes alters on a week-by-week basis.

WHAT IS BEBTELOVIMAB?

Bebtelovimab, made by drugmaker Eli Lilly, was given the green light by the United States Food and Drug Administration (FDA) in February to be used in adults and children older than 12 who tested positive for COVID-19 and are at high risk for severe disease.

The therapy, which is administered intravenously, is not approved for those who are hospitalized by the disease or those who require oxygen therapy.

An infusion of bebtelovimab takes just seconds in a process called an IV push, but the total visit requires around one hour of observation, both hospital officials said.

Paxlovid, an oral antiviral drug, is currently the preferred treatment option for most high-risk patients with mild to moderate COVID-19 symptoms. City health officials previously advised health providers to notify patients about available treatment options.

WHO SHOULD RECEIVE TREATMENT?

While the FDAs emergency use authorization enables a wide population to receive the treatment, top doctors at both borough health systems said a narrower group garners the most benefits.

Patients need to have at least one risk factor to receive the drug, but older patients especially see the most significant results.

This is really for the person over 50 who either has diabetes or lung disease or whos obese, said Maniatis, who added that the treatment administered in a timely way can reduce risk for severe disease progression by one-fifth.

Otterbeck said RUMC prefers to save monoclonal antibody treatments for those at the greatest risk.

The older the patient, the higher risk they are with respect to COVID, and consequently, we would like to use it for those patients, especially those who are above age 65, said Otterbeck. Or, the ones who are less than age 65 that have significant comorbidities.

HOW DO YOU RECEIVE THE TREATMENT?

Staten Islanders seeking monoclonal antibody treatments must first visit their primary care doctor to see if they are eligible.

Those being referred to SIUH will have to have their doctor schedule a visit through Northwell Healths centralized system. The doc who wishes the patient to have it fills it out, said Maniatis. It takes about 10 minutes and thats it.

The patient then receives a follow-up call before being given an appointment. Maniatis said the treatment is most effective when given just a couple days after initial symptoms arise, adding that waiting longer than a week will likely nullify the effects of the drug.

Otterbeck said patients are referred to RUMCs emergency room by their doctor, who uses discretion to decide which individuals are most in-need.

If they think the patients are appropriate candidates, they certainly can call ahead and speak to one of the ER doctors or refer the patients directly to the emergency department, he said.

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Are monoclonal antibodies still effective in treating coronavirus? Docs discuss where treatment stands. - SILive.com