COVID-19

WHO adds new recommendation for COVID-19 monoclonal antibody combo

The World Health Organization (WHO) today recommended another treatment for COVID-19, a monoclonal antibody combination from Regeneron already in use in the United States, though it urged companies and governments to make sure it’s accessible to lower- and middle-income countries.

Supply, drug administration challenges

The WHO’s conditional recommendation for the monoclonal antibody cocktail, which consists of casirimivab and imdevimab, applies to patients with nonsevere COVID-19 who are at high risk for hospitalization and for people who have severe and critical infections who have no antibodies to SARS-COV-2.

In November, the US Food and Drug Administration issued an emergency use authorization for the drug combination for adults and kids ages 12 and older who have mild- to moderate COVID-19. The combination is administered through intravenous (IV) infusion or injection. It made headlines when it was used to treat former President Donald Trump’s COVID-19 infection.

Demand for the treatment has been skyrocketing in US hot spots such as Florida, where officials have opened state-run centers to deliver the treatment. As a result, the Biden administration recently took steps to address shortages by taking over distribution and buying 1.4 million more doses. In the United States, the drug costs about $1,250 per dose and is covered by the federal government.

In a statement, the WHO said it welcomed the new treatment recommendation, but raised concerns about the high price and limited production, as well as safe and appropriate handling of the medicine.

It said UNITAID, a global health group, is negotiating with Roche to make the drug for a lower price and for equitable distribution to include lower- and middle-income countries. The WHO said it is also in talks with the company about donations that would be distributed through UNICEF.

Also, the WHO warned of possible challenges in rolling out the new antibody treatment, typically given by IV. In outpatient settings, injection administration at the lowest dose may be an option.

To support equitable treatment, the WHO suggested reserving doses for those known to benefit most from it: those without severe illness who are at high hospitalization risk and those with severe illness who don’t have antibodies, based on assessment with rapid tests.

More global headlines

  • South Korea today is expected to report record-high cases, as people return from autumn harvest travel, Yonhap News It notes that about 75% of cases are from the Seoul area. Officials eased gathering restrictions a bit over the holidays, but tightened them again today.
  • The nongovernmental health organization Oxfam said this week that Yemen is battling a third surge of COVID-19 activity, with cases recently tripling and deaths rising more than fivefold. It added that less than 1% of the country’s population has received one vaccine dose and that COVAX has delivered only 511,000 of the promised 4.2 million doses. More than 4 million people have been displaced due to conflict, resulting in a humanitarian crisis that, along with COVID-19, further weakens Yemen’s fragile health system.
  • The global total today rose to 230,912,407 cases, and 4,733,562 people have died from their infections, according to the Johns Hopkins tracker.

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