Are antibody treatments working for state’s patients?

Over 40,000 COVID-19 patients in Florida have received monoclonal antibody treatments during the pandemic’s summer surge, a statistic Gov. Ron DeSantis is touting as helping to keep people out of the hospital and save lives.

DeSantis has opened 21 clinics across the state, which offer Regeneron’s antibody cocktail to patients at no cost.

It’s difficult to quantify exactly how much of a difference the treatment is making in Florida’s latest outbreak without detailed studies, health experts say.

AdventHealth, Central Florida’s largest hospital system, is crediting some of the decline in its admissions to the wider availability of monoclonal antibody treatment.

“We do believe the Regeneron therapies are making a difference in reducing hospitalizations,” said Dr. Vincent Hsu, AdventHealth’s executive director of infection prevention. “I think we have made a difference in some people in giving these infusions.”

Statewide, about 14,886 people were hospitalized with COVID-19 Wednesday, down nearly 10% from a week ago, according to the Florida Hospital Association.

That decline could also be influenced by the natural course of the virus, Hsu said. Case numbers have leveled off or are falling in other hard-hit states, including Arkansas, Mississippi and Missouri. University models showed infections peaking in mid-to-late August in Florida.

‘Kept us from getting very sick’: Patients tout treatment

Patients who have gotten the treatment are trumpeting its benefits. The therapy has been available through AdventHealth since December, but it became more widely available in Central Florida with the opening of a state clinic at Camping World Stadium on Aug. 16.

Carl Ware, the senior pastor of Mt. Olive Seventh-day Adventist Church in Apopka, recalled being so sick and feverish with COVID-19 in January that he was willing to try anything to get some relief.

The 70-year-old minister wasn’t eating and feared he could be headed to an intensive-care bed. His asthma and age put him at higher risk of having a bad outcome.

Ware received the antibody treatment at the encouragement of his wife, who is a nurse, and started feeling better about six hours after getting the infusion.

He said he was fully recovered about a week later.

“I will stand on Mt. Everest and shout that I believe in my heart it’s because of the action we took getting those antibodies as soon as we did,” he said.

Michelle Paswaters, 53, of Winter Garden, got the COVID-19 vaccine but came down with a breakthrough case in July. Because she is immunocompromised, she signed up for antibody treatment, along with her 86-year-old father-in-law who also was vaccinated.

Both made a quick recovery after getting the infusion. Paswaters said she had a low-grade fever but her father-in-law, who had recently had a stroke, was sicker and could hardly walk.

“The combination of the vaccine and the infusion kept us from getting very sick,” she said. “I don’t think we would have gotten as better as quickly without the infusion.”

A Mayo Clinic study of about 700 patients treated from December 2020 to April 2021 found an early infusion of monoclonal antibodies reduced the hospitalization risk by about 60% to 70%.

The treatment has remained effective even with the highly transmissible delta variant, said Dr. Raymund R. Razonable, the study’s senior author.

“If patients can get access to this infusion, they should go for this,” he said.

About 5% of Orlando-area patients who received the antibody treatment through AdventHealth in August later required a hospital stay, Hsu said. That’s a good result, given that the people most at risk of having a serious illness are the ones eligible for the treatment, he said.

How does it work?

Patients need to get the treatment as soon as possible in their illness for the best results. Monoclonal antibodies are proteins that mimic the immune system’s ability to fight the COVID-19 virus. The treatment works by blocking the virus from entering cells, which stops it from replicating and spreading through the body.

Regeneron’s antibody cocktail can be administered in two ways. An IV treatment takes about an hour with another hour of observation required. The drug can also be administered through four shots given in a roughly five-minute span. The shots can be given at the thigh, upper arm or upper stomach.

It is available without a prescription because of a standing order issued by Florida’s surgeon general. Patients must be high risk and meet the criteria, though. Appointments can be made at patientportalfl.com.

The Food and Drug Administration has issued an emergency-use authorization for Regeneron’s treatment for high-risk patients 12 years and older. Risk factors include being overweight, older, or having diabetes or other underlying health conditions. High-risk people exposed to the virus but who have not tested positive are also eligible.

The federal government spent more than $2.6 billion on the drug, which costs about $2,100 a dose. It is being offered for free to patients, but providers can bill insurance for the cost of administering it. DeSantis says patients, regardless of insurance status, won’t be charged at the state sites.

The majority of people getting the treatment are unvaccinated, Hsu said. Still, he encourages vaccinated people to consider the treatment if they test positive and are at high risk, even though the vaccine is highly effective in preventing hospitalization and death.

“This is something that we believe the potential benefits are great with very minimal risk,” Hsu said.

Patients who receive the antibody treatment need to wait 90 days after their infusion to get a vaccine, he said.

Jay Wolfson, a public health professor at the University of South Florida, said the Regeneron treatment isn’t the way out of the pandemic, but it is helpful for people who catch COVID-19. Health experts say the vaccine is the best line of defense.

“Regeneron is the first real treatment we have gotten that appears to be successful, but it has limited use in the first 10 days,” Wolfson said. “It is a treatment, but it is not a cure.”

sswisher@orlandosentinel.com