Wilmington doctors explain monoclonal antibody treatment

WILMINGTON, NC (WWAY) — State health officials have been recommending a new treatment for people who have tested positive for COVID-19 called monoclonal antibodies, and two Wilmington doctors are explaining it.

Dr. Clyde Harris, Vice President of Clinical Excellence at Novant Health New Hanover Regional Medical Center, said the antibodies are designed in a lab specifically to attack a portion of the virus called the spike protein.

The spike protein is key in the virus getting into our cells and allowing the virus to replicate, so the antibody treatment is designed to prevent this.

“They bind to the spike protein and prevent it from binding to your cell and prevent it from entering your cell and therefore it cannot replicate. It begins to shut down replication. This is what you’re immune system would do normally and this is really an enhanced, early version of it,” Dr. Harris said.

Ideally, the antibody treatment is given through intravenous infusion (IV). Dr. Harris said it takes about 30 minutes to infuse and patients need to be monitored for an hour after infusion to watch for side effects. There is a possible, but very rare, side effect called anaphylaxis. Harris said less than 0.01-percent of patients have experienced this side effect.

The antibodies can also be given with a subcutaneous injection, which is a small needle under the skin. This injection is four shots around the belly button.

The treatment requires a referral from a physician and is only recommended for people who are at high risk for severe cases of COVID-19 or hospitalization. It must be given within 10 days of when symptoms began. The symptoms must be mild, so patients can’t be on oxygen, etc.

Medical conditions that put people at high risk include but are not limited to adults greater than 65 years old, obesity, diabetes, cardiovascular disease, and chronic lung diseases.

While the use of the treatment for COVID-19 is new, the technology is not. Dr. Paul Kamitsuka, Wilmington Health Infectious Disease Physician and Chief Epidemiologist at NHNHRMC, said monoclonal antibodies have been used to treat several conditions like cancer and rheumatoid arthritis.

Kamitsuka said current data shows the treatment reduces hospitalizations and death by 70-percent, but it’s in short supply and expensive.

“I would think about this treatment as an emergency, last resort if you have not been able to get vaccinated, or if you have an immune-compromising condition where the vaccines might not work as well and also have some of those other medical conditions,” Kamitsuka said. “It’s not something that we have enough of to give everybody and we would not have to give it very often if everybody got vaccinated.”

Something Kamitsuka frequently tells his patients is, “we’re very good at preventing COVID, but we’re not so good at treating COVID.” While the COVID-19 monoclonal antibody treatment is under Emergency Use Authorization by the FDA, he reminds people that the Pfizer vaccine is FDA approved and there is a mountain of evidence of its efficacy and safety.

For more information, visit the COVID-19 Treatment Guidelines page on the National Institute of Health’s website.

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