Monoclonal Antibody Treatment to Be Rolled Out to UK Hospital Patients With No Antibody Response

Eligible patients with COVID-19 in UK hospitals who have not mounted an antibody response against SARS-CoV-2 will be offered the monoclonal antibody treatment ronapreve from this week, the government has announced.

The drug is a combination of two monoclonal antibodies (casirivimab and imdevimab), which work by binding to two different sites on the SARS-CoV-2 spike protein and neutralizing the virus’s ability to infect cells. It was the first neutralizing antibody drug specifically designed to treat COVID-19 approved by the Medicines and Healthcare Products Regulatory Agency (in August 2021).

Ronapreve will be administered to patients without antibodies — who must be either aged 50 or over, or aged 12 to 49 and considered to be immunocompromised — through a drip. The government said it had secured enough supply for National Health Service patients across the four nations and that antibody testing will be used to determine which patients are eligible.

England’s health secretary, Sajid Javid, said:

“We have secured a brand new treatment for our most vulnerable patients in hospitals across the UK . . . The UK is leading the world in identifying and rolling out lifesaving medicines, particularly for COVID-19, and we will continue our vital work to find the best treatments available to save lives and protect the NHS.”

Japan was the first country to license the drug in July after a phase III trial reported that it reduced hospital admissions or deaths by 70% in high risk non-admitted patients. The treatment is administered either by injection or infusion and was found to reduce symptom duration by four days.

The combination of casirivimab and imdevimab was also tested as part of the UK’s Recovery trial, which concluded that it reduced the risk of death when given to patients admitted to hospital with severe COVID-19 who had not mounted a natural antibody response to the virus.

Originally published by The BMJ September 21, 2021, written by Elisabeth Mahase, reproduced here under the terms of the CC BY NC license.

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