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Local health care providers weigh in on changes to monoclonal antibody treatment guidelines

monoclonal web

BINGHAMTON, NY (WSKG) — The Food and Drug Administration recently limited certain monoclonal antibody drugs used to treat COVID patients, because they don't seem to be effective against the omicron variant.

When you’re exposed to a virus, your body usually responds by making antibodies to fight it off. Monoclonal antibodies are made in a lab. They don't stick around in the bloodstream for very long, but they can keep high-risk patients from ending up hospitalized, if used early enough.

“Early on in their infection, the monoclonal antibody would be used essentially to be the frontline of defense, or at least help the patient minimize their severity of illness,” said Dr. Justin Nistico, an infectious disease physician at Arnot Health.

The problem is, as COVID keeps mutating, some monoclonal antibody drugs don’t seem to work against new variants.

Maia Decker is the network inpatient pharmacy manager for Bassett Health, which treats high risk patients with monoclonal antibodies at outpatient sites. Decker said they noticed medications that worked very well against the delta variant simply don't work with omicron.

"It looks like omicron is going to be less susceptible," Decker said. "And that kind of developed into it looks like it's not going to be susceptible at all."

Decker said demand for monoclonals hasn’t overwhelmed Bassett’s capacity at this point, but supply is limited now.

That’s because the one type of monoclonal antibody drug that does seem to fight off omicron is in high demand.

“It's very limited. Every health care organization in the country is competing for the same fixed amount of monoclonal antibodies,” Dr. David Pfisterer, the chair of primary care for Guthrie Clinic, said. “What this has caused us to need to do is basically triage which patients are at the highest risk for progressing on to severe disease and ending up in the hospital."

But local health care providers emphasized while monoclonal antibodies are a useful tool, vaccination is still the most sustainable way to keep people from ending up in the hospital.

“We essentially have unlimited access to vaccines at this point. We do not have unlimited access to hospital beds. We don't have unlimited access to monoclonal antibodies,” Pfisterer said.

Experts say while there are new COVID treatments being developed, in the long term, vaccination may be more reliable because it helps your body create its own antibodies.

“If you're looking at COVID-19, what's the best way to prevent, treat, etc., it really is with vaccination because it provides you your own innate immunity, so that you have a fighting chance,” Nistico said.

Local health care providers also said while supply is limited, they’re getting fewer referrals for monoclonal antibody treatment. They’re hoping that means fewer people will need the treatment, perhaps due to the vaccine and omicron’s potentially milder symptoms.