Covid-19: Monoclonal antibody study in Bengaluru yields heartening results

The single-dose treatment costs Rs 59,000 and is substantially more economical than the current treatments

In what is one of the most sizable deployment of monoclonal antibodies in the city to date, 22 out of 30 Covid-19 patients who were administered the drug cocktail over the past four weeks, have recovered, doctors said.

The treatments were carried out at Manipal Hospital (Old Airport Road) in Bengaluru. The patients ranged in age from 19 to 70. In addition to Covid-19, they were suffering from serious comorbidities which placed them at high-risk of developing health complications, explained Dr Satyanarayana Mysore, Head of Pulmonology at the hospital. Five had cancer. The rest had diabetes and other complications.

The remaining eight patients, who were given monoclonal antibodies are still recovering. “Most recoveries happened within 24 to 48 hours,” Dr Mysore said.

A 19-year old patient was a severely obese young man with body mass index of between 38 and 40 and needed urgent surgery for gangrene of the bowels. “To conduct the surgery, the viral load needed to be brought down. With Remdesivir it would take five days. But with monoclonal antibodies, he was sitting up and better by the next day,” Dr Mysore said.

“This is a total game-changer in how we treat Covid-19,” he added.

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The single-dose treatment costs Rs 59,000, it is substantially more economical than the current treatments, Dr Mysore said. Patients spend less time in hospitals (the dose can be given as an outpatient treatment), their hospital bills are lower and there is reduced separation anxiety.

The cocktail comprises the drugs Casirivimab and Imdevimab. This combination was given emergency approval by the US Food and Drug Administration (FDA) in November 2020, and subsequently by the Drug Controller of India (DCGI).

Although a second cocktail (comprising bamlanivimab and etesevimab) was granted FDA emergency use approval in April 2021, Dr Adarsh C K, Chief Consultant Gastroenterologist and Hepatologist, BGS Gleneagles Global Hospital said that there was evidence to suggest that the Casirivimab-Imdevimab combination was more effective.

While other hospitals in the city have announced other monoclonal antibodies programmes, few have actually started. At BGS Gleneagles, two patients were given the treatment: one a 45-year-old man who was immunocompromised due to an organ transplant and an 83-year-old woman. “Within 24 hours, the 45-year-old was asymptomatic. The 83-year-old is also recovering,” Dr Adrash said.

Concern over misuse

While doctors described the treatment as a potent tool to be used in the predicted third wave, there is concern that it will be misused.

Doctors stressed that the cocktail can only be used for Covid-19 patients with mild or moderate symptoms, and who have been carefully assessed as being at high-risk due to comorbidities. “It should only be given to patients in the early phase of infection. Not when they require oxygen,” added Dr Prakash Doraiswamy, Senior Consultant (Critical Care), Aster CMI Hospital.

But there is concern that the cocktail’s success could work against it. “If too many people start demanding it, the people who need it the most are likely to be deprived,” Dr Adarsh said.