For those who have not been vaccinated or who have health conditions, which make it difficult to fight off infections even after full vaccination, monoclonal antibodies offer one of the most effective treatments of Covid-19. Unfortunately, the omicron variant, now the dominant strain across much of the U.S., is less responsive to two of the three versions of the treatment currently available.
According to LeeAnn Miller, vice president and chief pharmacy officer for Yale New Haven Health System, there are three companies currently producing the treatment for the U.S. market: Regeneron (which provided the treatment used by President Donald Trump during his 2020 infection), Eli Lilly and GlaxoSmithKline in collaboration with VIR Biotech. While all three were effective against other strains, only the GlaxoSmithKline has proven effective at lessening the severity of omicron.
“That really reduced our supply chain from three manufacturers with three products to one manufacturer with one product. And the manufacturer simply did not have enough availability at the time to keep up with the rapid surge that we ‘ve seen with this variant, ” Miller said.
Within the Yale New Haven Health System — which includes Bridgeport Hospital and Greenwich Hospital — Miller said that typically 100 vials of the GlaxoSmithKline treatment are delivered each week, which allows for the treatment of 100 patients each week. The current surge of hospitalizations means that the demand has also spiked, meaning even Yale New Haven Health has only half the supply needed to treat those infected with what Miller stressed is still a serious and dangerous virus.
“We are treating upwards of 700 patients a month, close to 200 a week, ” Miller said. “So, we are at least 50% there. ”
Monoclonal antibodies, which use artificial means to repeatedly clone the antibodies which a natural immune system produces in response to a virus, provide additional protection against viral illness by supplementing naturally produced antibodies. Unlike vaccines, which directly stimulate the body ‘s production, monoclonal antibodies are administered as an infusion via IV after a person has been infected and help reduce the severity of symptoms.
Unfortunately, just as different viruses require different antibodies, different mutations of Covid are fought more or less effectively by antibodies produced in either manner.
“It ‘s not a replacement to vaccination, ” Miller emphasized, “but it really is an important tool to help fight this disease. Especially those who remain high risk even though they have been vaccinated. ”
The U.S. Food and Drug Administration recently withdrew its authorization for the less-effective treatments, though they are still in production since other Covid variants, which have yet to emerge may be more responsive to those treatments. The Connecticut Department of Public Health issued a statement supporting that conclusion as well on Jan. 27.
“I know that GSK has reported that they have dramatically increased production, ” Miller noted of efforts to help close the gap between demand and supply. “And I believe that the U.S. has signed an agreement to purchase more units of that drug both in this quarter as well as next quarter so that should certainly be helpful.
“But I think we need two things: One is continued study to produce even more of these types of therapeutics that hopefully will have pan-sensitivity to all the different variants. The second is to continue the campaign to get more people vaccinated because that ‘s going to be the primary defense. ”
Miller hoped to see expanded availability of monoclonal antibody treatments outside of hospitals once supplies improve.
“That would just improve access, especially to patients who are home-bound and can ‘t get out of their house to get therapy, ” she said. “We could provide this through home infusion therapy programs and skilled nursing facilities. That would help overcome some of the challenges to reaching those vulnerable populations. “
