Timing, patient selection important factors for new antibody cocktail: Dr Nageshwar Reddy

AIG Hospitals chairman Dr D Nageshwar Reddy, said the real-world evidence of this monoclonal antibodies is yet to be established but the clinical studies published in peer-reviewed journals are encouraging

Hyderabad: The monoclonal antibodies-based treatment is seen as the latest armament in the fight against COVID-19, but is it really a wonder drug?

AIG Hospitals chairman Dr D Nageshwar Reddy, said the real-world evidence of this monoclonal antibodies is yet to be established but the clinical studies published in peer-reviewed journals including New England Journal of Medicine are encouraging as they have shown reduction in hospitalisation or death by over 70 per cent, including drastic reduction in viral clearance.

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In a virtual media meet here, Dr Reddy said the timing and patient selection becomes extremely important in administration of this therapy. “Patients over 65, obese patients with uncontrolled diabetes, cardiovascular patients, those who are under immune-suppressants like cancer patients are ideal candidates for this treatment. The timing also has to be appropriate since it needs to be given within three to seven days at the maximum,” Dr. Reddy said, adding that this can be given to patients above 55 if they have heart related issues like hypertension.

Stating that within a week, this treatment can help patients become RT-PCR negative, he said pregnant women should not be administered this treatment since there was not enough safety data for this subset of patients. “There is also a possibility to explore the prophylactic usage of this combination especially among the high-exposure groups like healthcare workers. This has to be highlighted that since as per US FDA, benefits of this antibodies cocktail have not been observed in patients hospitalized due to COVID-19. Moreover, if this combination is administered on patients requiring high-flow oxygen or mechanical ventilation, then the clinical outcomes can become worse,” he said.

Explaining how monoclonal antibodies work, Dr Reddy said they bind to the spike proteins of the virus (S1 and S2) and thereby limit its replication. “Mutation in the virus can impact the effectiveness of this monoclonal antibodies’ treatment. Although the effectiveness against some of the variants have been proven, we are not sure about how it will go against the double mutant B.1.617, the so-called Indian variant,” he said.

“At AIG, we are doing a major study where we are looking at its efficacy against the double mutant variant of the virus,” Dr. Reddy said, adding that this treatment has the potential to increase mutant variants and that is why irrational use of these antibodies’ cocktails should be absolutely discouraged.

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