INFORMATION ON MONOCLONAL ANTIBODY TREATMENT FOR SARS-COV-2

Treatment with monoclonal antibody therapies continues to be recommended for certain patients with COVID-19 who are at high-risk of progression to severe disease.

Anti-SARS-CoV-2 Monoclonal Antibody Treatment Information

Monoclonal antibodies that target the spike protein have been shown to have a clinical benefit in treating SARS-CoV-2 infection. Three anti-SARS-CoV-2 monoclonal antibody products currently have Emergency Use Authorizations (EUAs) from the Food and Drug Administration (FDA) for the treatment of mild to moderate COVID-19 in non-hospitalized patients with laboratory- confirmed SARS-CoV-2 infection who are at high risk for progressing to severe disease and/or hospitalization.

Bamlanivimab plus etesevimab: These are neutralizing monoclonal antibodies that bind to different but overlapping epitopes in the spike protein receptor binding domain (RBD) of SARS- CoV-2.

Casirivimab plus imdevimab: These are recombinant human monoclonal antibodies that bind to nonoverlapping epitopes of the spike protein RBD of SARS-CoV-2.

Sotrovimab: This monoclonal antibody was originally identified in 2003 from a SARS-CoV survivor. It targets an epitope in the RBD of the spike protein that is conserved between SARS-CoV and SARS-CoV-2.

The FDA also updated the EUA for casirivimab plus imdevimab as post-exposure prophylaxis for certain individuals who are at high risk of acquiring SARS-CoV-2 infection and, if infected, are at high risk of progressing to serious illness.

Patient Eligibility

Monoclonal antibodies continue to be authorized for the treatment of mild to moderate COVID- 19 in adults and pediatric patients (12 years of age and older weighing at least 40 kg) with positive results of direct SARS-CoV-2 viral testing, and who are at high risk for progression to severe COVID-19, including hospitalization or death. Treatment should be given as early as possible, and within 10 days of symptom onset.

However, the criteria for determining which patients are considered high-risk for progression to severe COVID-19, and therefore eligible for treatment with monoclonal antibody therapy, have been updated. Providers can now consider other medical conditions or factors (for example, race or ethnicity) that may place individual patients at high risk for progression. High-risk factors include but are not limited to Age >65, Obesity (BMI >25), Pregnancy, Chronic Kidney Disease, Cardiovascular Disease (including Hypertension), Diabetes, Chronic Lung Disease, Immunosuppressive Disease or Treatment, Neurodevelopmental disorders or medical related technological dependence. Healthcare providers should consider the benefit-risk for an individual patient.

Details on eligibility can be found in the “Fact Sheets for Healthcare Providers” at: https://combatcovid.hhs.gov/sites/default/files/documents/High-RiskCOVID_19Patients- 062021.pdf

Locations offering Monoclonal Antibody Treatment

Saint Alphonsus Health System 208-367-DOCS (3627) for questions and referrals Patients meeting eligibility for mAb treatment presenting to the emergency department or urgent care locations present with illness at our emergency department or urgent care locations will be evaluated and connected to an appointment.

St. Luke’s Health System (treatment available in Boise, Meridian, Nampa, Mountain Home, McCall, Fruitland, Hailey and Twin Falls) Scheduling call: 208-706-0646 Orders fax: 208-706-5136

*Long Term Care Facilities may contact Red Rock Pharmacy, Meridian, ID 208-288-1200 Connect Pharmaceuticals, Eagle, ID 208-593-0133

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