City pvt hospitals adopt monoclonal antibody cocktail therapy to reduce severity of virus
MUMBAI: Private hospitals in the city are using the monoclonal antibody therapy – a new antibody cocktail treatment that was used to treat former US President Donald Trump – in the treatment of Covid-19 patients. Doctors claim that though the method does not cure the infection, the treatment helps in preventing the development of Covid-19 severity among mild to moderately infected patients with severe comorbidities, if administered within seven days of the infection.
Antibodies produced naturally in bodies fight against diseases. Monoclonal antibodies, too, work similarly, and help in defending against the disease but are made artificially in a laboratory. Casirivimab and Imdevimab are monoclonal antibodies that are specifically directed against the spike protein of Sarscov-2 (the virus that causes Covid-19), which help in blocking the virus’ attachment and entry into human cells.
The two antibodies of 600 milligram each are mixed like a cocktail. It is administered intravenously or subcutaneously (under the skin) like an injection. If it is given subcutaneously, these injections can be given at four spots in the body. A full dose of an antibody cocktail is given to the patient within 30 minutes. The patient will then be monitored for an hour to check for any reactions.
The therapy has been used to treat Ebola and HIV.
The Drugs Controller General of India (DCGI) approved the therapy in May, after which some private hospitals in the city such as Nanavati Max Super Speciality Hospital (Vile Parle) and Wockhardt Hospital (Mira Road) started using the method.
Since June 1, Nanavati Hospital has successfully treated four patients with multiple comorbidities using the therapy. Dr Salil Bendre, consultant pulmonologist at the hospital, said a 58-year-old severely obese, chronic smoker, weighing 130kg, with a history of severe obstructive sleep apnea syndrome was the first to receive the antibody cocktail at the hospital. “He was a high-risk patient with no hypoxia, but had mild symptoms like body ache. As the patient had tested positive on May 30, we decided to administer the monoclonal cocktail to avoid the development of severe Covid-19 complications. Despite severe comorbidities, the patient didn’t develop any further ailments. Two weeks on, his condition is now stable,” Dr Bendre said.
In another case, a 50-year-old woman weighing 125kg with a history of poliomyelitis, hypertension and borderline diabetes with mild Covid-19 infection showed improvement after receiving the therapy. Her doctor, Dr Girish Parmar, who is a senior consultant, endocrinology and diabetology at the hospital, said, “The woman visited us on the seventh day of her Covid-19 infection. She was mildly symptomatic with cough and fever. As she was a high-risk patient, we decided to administer the monoclonal antibody cocktail within the initial window of disease advancement.”
Wockhardt Hospital has treated two female patients above the age of 60 with comorbidities like diabetes, kidney disease and high blood pressure, using monoclonal antibody therapy. Dr Jinendra Jain, consultant physician at the hospital, said, “The therapy is for those above the age of 65, home isolation patients having an oxygen saturation of 93% or require no oxygen support but are at risk of developing a severe form of the infection owing to comorbidities such as obesity, diabetes, liver disease, heart ailments, and chronic lung disease.” However, he also said that the therapy is not recommended for patients who have severe Covid-19 infection, require oxygen therapy and have allergies.
Doctors have cautioned about over-emphasising the term ‘lifesaving method’. “Yes, it has helped in reducing the viral load, shortening the duration of the treatment and lowering the probability of hospitalisation. But if a patient’s condition is serious, then the method should be avoided,” said Dr Lancelot Pinto, consultant pulmonologist, Hinduja Hospital.